Using Low FODMAP Foods to Help with Gas, Bloating and GI Issues

Using Low FODMAP Foods to Help with Gas, Bloating and GI Issues

“There’s not much we can do.” This is the essence of almost every Western doctor who has tried to help a patient suffering from irritable bowel syndrome (IBS) or related symptoms (gas, bloating, abdominal pain, diarrhea, constipation, etc.). I am not here to bash on Western doctors; in fact, I come from (and love) them! But with regards to food intolerances and GI-related food issues, I have had first-hand experience with the lack of help or guidance, and have helped many patients with similar experiences.

Nearly 10-15% of the population has actually been diagnosed with IBS, which is a staggering statistic as is. But let’s talk about the nearly 3.5 million doctor visits each year that are for IBS-related symptoms. And the $21 billion dollars spent annually on IBS problems. This is a serious issue! And diet is the foremost player in helping to manage – and even reverse – these issues. 

To review our digestive anatomy quickly: the bulk of our nutrient absorption occurs in the small intestine. The large intestine is responsible for the absorption of water and to also prepare undigested food for removal from the body (in the form of feces). When certain foods pass to the large intestine because they were not properly absorbed, however, it can cause some of the following symptoms:

·      Bloating

·      Distension

·      Lower abdominal pain

·      Excessive gas (or foul-smelling gas)

·      Altered bowel movements (i.e. diarrhea, constipation, or a combo of both)

There are many known inflammatory foods that can cause IBS-related symptoms. Gluten (from wheat products), dairy, foods high in saturated fats, and alcohol are a few of them. If you have tried eliminating or reducing these foods already and have still not found relief from your bloating or GI issues, you might consider following a low FODMAP diet. 

FODMAP is an acronym that stands for a group of dietary sugars called Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides and Polyols. FODMAPS are short-chain carbohydrates that are rapidly fermented and, for some, can be poorly absorbed in the small intestine. 

Fructose:

Let’s begin by discussing the smallest FODMAP: fructose. Fructose is a monosaccharide which means that it is already in its simplest form chemically, and therefore cannot be broken down any further. Because fructose is in its smallest form, it can have the greatest effect on attracting water into the bowels. This means that when fructose is eaten in excess, it can cause diarrhea, abdominal pain or bloating. For about 30-40% of people (both healthy people and those with known IBS), excess fructose can cause malabsorption. Fructose can be found in certain fruits, honey and some high fructose corn syrups too.

You may be thinking: hold up! I thought fruits are healthy for me. Yes - they are! But anything in excess can cause issues. This is true for anything in life. This doesn’t mean that eating fruit should be avoided, especially if you don’t have an issue absorbing fructose. Fruits and honey provide a wide range of nutrient-dense vitamins, minerals, and fiber that we need. But if you are experiencing IBS-like symptoms and can’t seem to resolve them, it might be worthwhile to take a closer look at the types of fructose you are consuming, and also in what quantities. Not to mention, we need a certain amount of glucose (another simple sugar that our body uses as fuel) in order to effectively digest fructose. So if the ratio of glucose to fructose is disproportionate to fructose, this can cause a problem. 

Lactose:

Lactose, which is found in dairy and milk products, is a disaccharide which means there are two sugar units joined together. Since it’s not yet in its simplest form, we need an enzyme called lactase in order to break the two sugars apart for further digestion. The lactase enzyme is found in the wall of our small intestine. Many people in our modern society lack this enzyme, which means lactose will pass through the small intestine undigested and then ferment in our large intestine. This can cause a variety of issues. More mildly, it can cause gas or bloat. On the more severe end, it can cause diarrhea, abdominal pain or even constipation in some.

Polyols

Sorbitol and mannitol are two of the most common polyols and can be found in certain fruits and vegetables, as well as added as artificial sweeteners to things like gum, for instance. Most people who have an issue with polyols are likely going to struggle to absorb sorbitol, but most will benefit from removing mannitol as well. Polyols, like fructose, are fairly small and can cause diarrhea and abdominal pain due to the pulling of fluid into the large intestine. 

Oligosaccharides (Fructans)

Interestingly, no human has the enzyme to digest oligosaccharides or galacto-oligosaccharides which are most commonly found in wheat, rye, onions, garlic, legumes and lentils. However, for people without IBS or GI issues, these foods actually benefit our gut microbiome by giving the living organisms food (also known as prebiotic) and helping them to diversify. However, in people with sensitive GI system, these foods can exacerbate GI symptoms and cause altered gut motility. 

The idea behind the low FODMAP diet is not necessarily that you eliminate all high FODMAP foods forever. In fact, it’s just a starting point. As with any food elimination diet (and there are many different ways to go about doing one, depending on your health conditions and goals), the low FODMAP diet will temporarily eliminate foods high in FODMAPS for a certain period of time (~2-6 weeks). Then you will slowly and strategically (with the help and guidance of a Registered Dietitian) add them back into your diet giving your body time to react and adjust to each food. If you have adverse symptoms after a food introduction (like bloating, for instance), you will want to keep that particular food out of your diet. If you eat a food and it “passes” the symptom test, then you can keep it in your diet because it’s likely not the cause of your issues. Assuming that foods continue to pass the test, you can keep those in your food repertoire, and leaving out the ones that we’ve deemed as intolerable for your system.

So let’s talk about which foods are high in FODMAPS. Here’s a list of what to avoid during your full reset (Special thanks to Monash University for such a comprehensive list!):

Fructose:

• Asparagus, artichokes, sugar snap peas, apples, boysenberries, figs, dried-fruit, fruit bars, mango, nashi pears, pears, tin fruit in natural fruit juice, tamarillo, watermelon, feijoa, apple juice, fruit blends, high fructose corn syrup

Lactose:

• Cow’s milk, condensed milk, yogurt, custard, evaporated milk, ice cream

Oligosaccharides (Fructans):

• Garlic, leeks, onions (red, white, shallots) artichokes, wheat flakes, cereal, roti bread, pasta wheat, pearl barley, dried apricot, peaches, watermelon, banana

Galacto-saccharides

• Butter beans, green peas, pistachio, cashew, custard apples, soy milk (made from whole soybean), and oat milk

Sorbitol (Polyol):

• Apples, apriocots, blackberries, nashi pears, nectarines, peaches, pears, plums, artificial sweeteners (i.e. sorbitol, mannitol, xylitol, isomalt)

Mannitol (Polyol):

• Cauliflower, mushrooms, snow peas, clingstone peach, watermelon

You might be asking yourself what can you eat during your elimination? So many things! For example, you can eat the following (this is not an exhaustive list):

Veggies:

• Eggplant

• Spinach

• Broccoli

• Carrots

• Celery

• Brussels Sprouts

• Cucumber

• Bok Choy

• Bell peppers

• Peas

• Potato

• Okra

• Olives

Fruits:

• Avocado

• Banana

• Blueberry

• Cherries

• Cantaloupe

• Grapes

• Mandarin

• Lemon

• Pineapple

• Raspberry

• Strawberry

• Pomegranate

Proteins:

• Chicken

• Eggs

• Red Meat (in moderation)

• Fish/Shellfish

• Tofu

• Tempeh

Flours:

• Buckwheat

• Cornflour

• Millet

• Quinoa

• Rice

• Potato Tapioca

Beverages:

• Coconut water

• Cranberry juice

• Kombucha

Once the elimination period is completed and all FODMAP foods have been removed from your diet, your body will be at a neutral baseline, and you can begin to reintroduce foods back into your diet. It’s imperative that you work with a qualified Dietitian during this process in order to plan your food reintroduction appropriately and safely. This is to be done slowly, strategically, and one food at a time. You will need to allow a few months to get through all of these foods. The process will become easier over time as you are able to add more foods into your diet that don’t cause you issues.

This strategy (as with any food elimination diet) will give you a deeper and more meaningful insight into how your body works and what your unique food needs are. Patience and determination are needed, and a supportive team around you (both professionally and personally) will make the journey that much easier to bear.

If you have questions or want to embark on a food elimination diet to figure out your issues, reach out and we can figure out the best plan for you!