Practitioners

What is the FODMAP diet?

Have you heard of the FODMAP diet but are confused about who it’s for? Have you tried it only to reintroduce foods again and you’re back to bloating and stomach pain? Do you have IBS and wonder if it’s right for you? If you’ve answered yes or are curious about the FODMAP diet, then this blog is for you!

FODMAP

The FODMAP diet has been around since 2001 but only 12+ years later did it begin to gain significant evidence for it to be used widely to help people with digestive issues, including IBS and SIBO.

 

However, the more common the diet has become the more it is misused and poorly managed. At Integral Wellness, we frequently meet people who are currently or have previously followed the low FODMAP diet but without much understanding of why.

 

As Nutritional Therapists, we love asking WHY and educating our clients and those who read our content on the ins and outs of wellness tips and nutrition. The more you know, the more empowered you are over your health and the decisions you make. That’s why Natalie and Krista have teamed up to answer 10 of the most common questions relating to the FODMAP diet so you are clearer about its purpose.

 

What is the FODMAP diet?

FODMAP stands for Fermented Oligosaccharides, Disaccharides, Monosaccharides And Polyols. The ODM And P are all types of carbohydrates that the intestines may absorb poorly and therefore they begin to ferment in the gut, causing symptoms such as:

  • Diarrhoea or constipation
  • Bloating
  • Cramping and stomach pain
  • Gas and flatulence

The FODMAP diet seeks to remove all foods that can contribute to carbohydrate fermentation in the gut.

 

Does the FODMAP diet work for IBS?

IBS (Irritable Bowel Syndrome) is one of the main digestive issues that can be supported with the low FODMAP diet. Scientists at Monash University in Australia developed the FODMAP diet in 2004 in a bid to help the growing number of people suffering from IBS symptoms. The fermentable carbohydrates are often the culprits for some of the typical IBS symptoms such as bloating, pain and gas. 

Small Intestinal Bacterial Overgrowth, known as SIBO, can also contribute to FODMAP intolerance. 

 

What is SIBO?

SIBO is when there are too many bacteria in the small intestine, increasing gas levels and encouraging more bacteria to grow. In a healthy gut, the large intestine is where the majority of the bacteria (aka microbiome) live. The small intestine should carry far fewer microbes. This is because the small intestines’ role is to absorb our food and too many bacteria can interfere with this process.

SIBO can also cause similar symptoms to IBS – bloating, stomach pain, diarrhoea, constipation, gas, and nausea. A qualified Nutritional Therapist will be able to support and identify the likelihood of SIBO versus IBS.

 

How do I know if I have SIBO and not just IBS?

The most reliable way to find out if you have SIBO and not just IBS is to do a SIBO breath test! Bacteria normally found in the large intestine produce gases such as hydrogen and methane through the fermentation of sugars. These bacteria, however, can sometimes move into the small intestine which causes an overproduction of methane and hydrogen (causing bloating, diarrhoea, flatulence etc) which are then absorbed in the bloodstream, and transported to the lungs where they can be exhaled and caught in a breath test. You’ll see the overgrowth of bacteria on a comprehensive functional stool test as well which can indicate SIBO.

We offer functional testing as part of our support at Integral Wellness. Book a free call to find out how we can help you test for answers.

 

How do you get SIBO?

 There are many ways in which someone may develop SIBO, the most common causes are: 

  • Insufficient stomach acid – stomach acid is designed to kill bacteria that you may consume. If you don’t have enough stomach acid to kill bacteria they can end up in your small intestine and multiply.
  • Low levels of bile – also a protective defence against bacteria. If bile isn’t flowing properly, or you’ve had your gallbladder removed, bacteria can overgrow in the small intestine.
  • Lack of digestive enzymes – if you don’t produce enough enzymes to digest your food, it can begin to feed your gut bacteria and they can overgrow. Chewing your food properly can help with the digestive process as the saliva we get from chewing contains these digestive enzymes needed to break down food and reduce the risk of bacteria overgrowths. 
  • Compromised immune system – our immune system is designed to fight off any unwelcome bacteria. If it doesn’t work as well as it should, bacteria can grow and multiply in the small intestine, contributing to SIBO.
  • Chronic stress – the gut-brain connection means that long-term stress can have an impact on the balance of the gut microbiome due to the inflammation and hormone changes stress causes.
  • A defect in the small intestine – between the small and large intestines is a ‘door’ designed to ensure food flows in one direction from the small to the large intestine. If the ‘door’ (aka the ileocecal value) doesn’t close as it should, bacteria can migrate into the small intestine where it shouldn’t be.
  • Crohn’s Disease – An inflammatory bowel disease (IBD) which is characterised by inflammation of the gastrointestinal tract. This inflammation can compromise the integrity of our gut lining which plays a role in protecting us against certain negative bacteria. Having CD can also lead to a compromised immune system, insufficient stomach acid and a defective ileocecal valve, all protective factors against SIBO.  
  • Diverticulitis – A condition that occurs when the small pouch which sticks out from the wall of the colon (diverticulum) becomes infected or inflamed. Just like with Crohn’s disease, diverticulitis can compromise the immune system and other protective factors against SIBO. 
  • Food poisoning – When exposed to food poisoning, your body produces antibodies to fight off the illness. These antibodies attack certain proteins that can affect the motility in the small intestine which can lead to the development of SIBO. 

 

Do I have to be on low FODMAP for life?

FODMAP diets are restrictive, so are only recommended for short-term use. The aim is to slowly reintroduce FODMAP foods into your diet which can help identify which foods are troublesome. Once you know which foods are triggering your symptoms, you may need to restrict these for a while whilst working on healing your gut with a Registered Nutritionist. The time scale will be different for everyone, but often it’s only a few foods that people are sensitive to, so you may not need to restrict yourself by cutting out all FODMAP foods. 

 

Is a low fodmap diet healthy?

Although the low FODMAP diet is useful for people to understand what foods are triggering their symptoms, it shouldn’t be done long-term. Going on a low FODMAP diet for too long could mean you are missing out on key nutrients, vitamins and minerals as well as beneficial prebiotics which feed the good bacteria within your gut. These good bacteria are necessary for our overall health and wellbeing, including our immune system, mental health and hormone balance.

 

It’s important to work with a Registered Nutritionist who can guide you on the FODMAP diet; how to implement it and reintroduce foods after 8 weeks or so.

 

We see a lot of people who have been told to go on the low FODMAP diet and then begin reintroducing food but without any support for healing the gut and addressing the root cause of their digestive issues. This can be really frustrating for individuals as in a matter of months their issues return so they often feel long-term low FODMAP diet is the only way to go as it was the only time they felt well. 

 

The answer isn’t low FODMAP forever, it’s to fix the root cause of your issue while you’re on low FODMAP so you get long-lasting gut health improvements and no more symptoms.

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