When Everyday Foods are Hard to Digest                                  


At some point as many as 20% of adults suffer from a painful digestive disorder that is difficult to diagnose and has no cure.  Treatment is hit-or-miss, and many sufferers never seek help because they find symptoms hard to discuss.  Irritable bowel syndrome (IBS) has long baffled gastro-intestinal experts.  Some think it is caused by imbalances in gut bacteria; others point to psychological stress.  Now, a small but growing contingent of specialists is focusing on food intolerances as a possible culprit—and a new dietary approach, called the low FODMAPs diet, is gaining attention.

The theory is that many people with IBS have trouble absorbing certain carbohydrates in their small intestines.  Large molecules of those foods travel to the colon, where they are attacked by bacteria and ferment, creating the telltale symptoms of gas, bloating, constipation or diarrhea.   A long list of foods-- including dairy products, some fruits and vegetables, wheat, rye, corn syrup and artificial sweeteners—can potentially create problems in susceptible people.  Collectively, they’re known as FODMAPs, an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.  Polyols are also known as sugar alcohols.

The low FODMAPs diet recommends eliminating all of those foods for a period of six to eight weeks, and then gradually adding back one group after another to identify which cause the most trouble.  Eventually many IBS sufferers find they can tolerate most foods on the list as long as they keep the total amount of FODMAPs under a certain level. (It’s not like having celiac disease where people can never eat gluten.)  Some small studies have shown that  the diet can reduce IBS symptoms in about 75% of sufferers—higher than other diet or medication approaches. 

Although the low FODMAPs diet is relatively unknown in the US, a presentation about it at the American College of Gastroenterology conference drew a rapt audience.  Word is also spreading among those who suffer with a multitude of GI problems.  Many who have tried it can’t believe how much it’s changed their lives.  Understanding what one can and cannot eat can alleviate symptoms for the first time in some sufferers’ lives.  One of the biggest advantages is that it puts people in control of what they need to do to avoid symptoms. 

The FODMAPs approach doesn’t make everybody better, but it makes a lot of people significantly better.  Because so many foods have FODMAP components and reintroducing them can be tricky, IBS sufferers shouldn’t try the diet on their own.   A growing number of dietitians are being trained, and many GI physicians can assist patients in understanding the diet.  GI doctors can also rule out more serious causes of symptoms, such as celiac disease, inflammatory bowel disease, or colon cancer. 


Please click this FODMAPS  link to review the article and FODMAP chart.


Source: Melinda Beck, The Wall Street Journal