FOD-What? If you have irritable bowel syndrome, you’ve probably heard a lot about FODMAPs. FODMAPs is an acronym that stands for Fermentable Oligo-, Di-, and Mono-saccharides and Polyols. In plain language? FODMAPs are specific carbohydrates that are poorly digested by most people. Since they are not absorbed, they travel through the digestive tract where they can either draw water into the gut (which loosen stools) or become fermented by gut bacteria to cause gas, bloating and inflammation. Understanding FODMAPs Our understanding of FODMAPs is thanks to two researchers from Monash University in Australia, Dr. Sue Sheppard RD and Dr. Peter Gibson MD. They discovered that these FODMAPs could exacerbate the symptoms for those suffering from Irritable Bowel Syndrome (IBS), and elimination can help improve symptoms in roughly 80% of those with IBS1. FODMAPs are found in many of our everyday foods: Lactose in dairy products Excess fructose in apples, pears, cherries and agave syrup Fructan chains in garlic, onions, beans and wheat Polyols in cauliflower, mushrooms and xylitol You’ve probably noticed that FODMAPs are found in some of our healthiest foods, like beans, fruits and vegetables. So how exactly can they make you feel worse? All of the FODMAPs, by a quirk of their structure and our physiology, tend to be only partially or even entirely undigested. Our ability to tolerate FODMAPs is individualized. And, if we don’t have irritable bowels, we may not even be bothered by our lack of digestive ability. In fact, the very nature of FODMAPs is what makes them potentially beneficial to general digestive health. If you have a healthy gut flora, undigested carbohydrate chains will feed those beneficial bugs, keeping your gut happy and healthy. All of this talk about prebiotics? Well, the best studied prebiotic is inulin, which is also a FODMAP2. So, interestingly enough, we have plenty of evidence to encourage the general population to consume MORE FODMAPs. We all might get a bit gassy after we eat a big bowl of baked beans…but that can be good for us. However, those of us with IBS will feel horrible after the same meal because of the changes in gut flora and nervous system response in the gut. Those with IBS may experience more inflammation due to the mix of microbes in the gut, or an overgrowth of microbes in the small intestine3. Typical gas production in the intestines may cause a significant amount of pain, and the normal rate of movement in the gut can be altered due to changes in the enteric nervous system. So altering fermentation or water content of the stools can bring about incredible relief for those who suffer from irritable bowel syndrome. Is a low FODMAP diet right for you? If you have irritable bowel syndrome and have been having difficulty managing your symptoms, it’s worth giving a low FODMAP diet a try. In fact, it’s the gold standard dietary therapy for IBS and has been shown to work for most people for whom diarrhea is a common symptom (as opposed to constipation). The diet has not been adequately studied in other concerns such as Crohn’s Disease or non-IBS bloating; however, anecdotally, it has been an effective strategy for bringing relief. If you have IBS or ongoing challenges with significant gas and bloating, and your physician has ruled out more serious culprits, it might be worth giving a low FODMAP diet a try. Before you try this diet, a few things to consider The first is that you have to be 100% committed for the elimination to work. You can’t just follow it at most meals – you need to totally avoid high FODMAP foods to allow your digestive system to heal. Secondly, a low FODMAP diet is not meant to be a long-term eating strategy. Why is that? Well, the low FODMAP diet works, in part, by starving your gut bacteria4. For a short period, this can help bring your system back into balance. However, in the long-term, this likely isn’t a very good idea because a healthy gut flora is important for digestive health, nervous system health and immune function. A few trials are looking at the long-term use of the diet, but initial evidence suggests that the diet actually does lower bacterial count and diversity. The third important point to remember is that a low FODMAP diet should be just part of your digestive healing strategy. Taking care of your stress levels and mental wellbeing needs to be addressed in addition to providing nutrients that facilitate gut healing and repopulating the gut with beneficial bacteria. Because of the deep connection between the brain and the gut, psychological stress can strongly exacerbate symptoms of IBS, making it seem like the low FODMAP protocol isn’t working. Also, because low FODMAP diets alter gut bacteria, using a probiotic like Bio-K+ is critical to help support a rebalanced flora for long-term gut health. How to use low FODMAP diets as part of a healing strategy While you can find most of the information you need to follow a low FODMAP diet online, I do recommend you work with an experienced registered dietitian to help tailor your approach and guide you. Typically, the elimination protocol for this diet is 2-8 weeks in combination with other mind-body approaches to healing. Next comes a slow, systematic reintroduction of FODMAPs to pinpoint a person's individual level of tolerance. Some people may restore their ability to consume all FODMAPs, as long as they don’t go overboard, say eating a big bowl of garlicky fettuccine alfredo followed by an ice cream sundae! Bio-K+ is effective and clinically proven to help fight pathogenic strains of bacteria and improve gas and bloating. For those following a low FODMAP diet, give a try to the blueberry fermented organic brown rice because it is free of FODMAP-containing legumes. It seems that an increasing number of us are having challenges with our gut flora but luckily there is so much we now know about how to restore a healthy balance. If you have IBS or significant gas or bloating, talk to your dietitian about using a low FODMAP diet along with a clinically proven probiotic like Bio-K+ to help get you back to feeling good. For more information on Bio-K+, probiotics and digestive health, contact us, find us on Facebook and Instagram or join the community. To stock up on Bio-K+, head to our store locator. References https://www.ncbi.nlm.nih.gov/pubmed/27382323 https://www.ncbi.nlm.nih.gov/pubmed/25179725 https://www.ncbi.nlm.nih.gov/pubmed/24857420 http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1028.9451&rep=rep1&type=pdf
