IBS and a Low FODMAP Diet

When I was 22 I started having debilitating digestive symptoms. I went to several doctors and eventually we ruled out everything else, which left IBS as the diagnosis. IBS or Irritable Bowel Syndrome is a fairly common problem, though it often goes undiagnosed. While there are some medical interventions doctors most often suggest trying lifestyle adjustments first. These mostly revolve around diet.

The diet that I have heard the most about in recent years in relation to IBS is a Low FODMAP diet. FODMAP stands for Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols. Put in layman's terms these are each types of sugar that some people’s bodies are not able to digest and absorb properly. Lactose, for example, is a disaccharide. We all probably know people who are lactose intolerant. The idea here is that there are other sugars that some people have trouble with similar to lactose intolerance. When a person consumes those sugars they ferment in the digestive tract, which leads to painful bloating and bowel issues.

The low FODMAP diet was first hypothesized in 2005 but despite being diagnosed with IBS in 2011 I didn’t hear about it until 2017. It was developed and researched at Monash University in Australia and seems to be effective at reducing symptoms in about 75% of IBS sufferers. I want to clarify that this is not a fad diet, and it is not designed for weight loss. It’s designed to reduce symptoms of IBS and improve quality of life for people who have IBS.

For me it has been a game changer. Before I started on this diet I didn’t have any idea how to feed myself effectively. I struggled for years with a severity of symptoms that often made me have to miss work and limited my social life in huge ways. Since starting this diet I have mild to no symptoms the vast majority of the time. I still will have the occasional flair up but that is no longer my normal. I remember before I started this diet my doctor told me that if I didn’t feel so much better within 2 weeks that I wanted to keep doing this forever that I shouldn’t do it. It can be pretty restrictive and isn’t really designed for people to follow all of it, all the time. There are several categories of sugars and generally you can narrow down which categories seem to give you the most trouble and limit your intake of those. For me I have to limit my lactose, fructose, and artificial sweeteners.

Another important note about this diet is that you don’t have to completely cut these things out of your life. You only have to limit them. Sometimes the limits can be absurdly low but sometimes they are actually pretty reasonable. One food that gives me trouble is peaches. But when peaches are in season they are just so delicious. It turns out I can handle about a third of a peach at a time without any problems, so often my husband and I will share one. I don’t get to binge peaches but I also don’t have to totally deny myself something delicious and enjoyable. The recommendation is to allow 3 hours in between servings so theoretically I could eat a whole peach if I just space it out throughout the day. That might sound like a pain in the ass but after 5 years of debilitating symptoms having to space out my peach thirds is truly the least of my concerns.

If your doctor has recommended trying a low FODMAP diet you may be unsure where to begin. I’m hoping to point some people towards some resources that I have recently become aware of and that I wish I had had access to early on in my IBS journey. First up and I think most important is the Monash University FODMAP Diet app. It costs $8 but it has been so worth it. It has a food guide section that breaks down foods based on the different kinds of sugars they contain. Using a red, yellow, and green light system you can see what serving sizes are recommended, which are questionable, and which are likely to cause symptoms, all organized by individual sugar type. This is sup2er helpful once you have identified which sugars you have the most trouble with since some foods that are technically high FODMAP will be high in sugars you tolerate better, and therefore you can eat those things.

The app also offers recipes and lists brands that are certified Low FODMAP. You can keep track of how the diet is going in a calendar style food diary in which you can record what you eat, what symptoms you experience, stress levels, and stool consistency. There are informational ‘booklets’ available for free on the app covering a range of topics. And lastly a directory of dieticians who are knowledgeable about the FODMAP diet in many countries around the world. If you are in the US you can search by state.

Another resource is modifyhealth (https://modifyhealth.com/). This company provides low FODMAP meals, fully cooked and delivered to your house weekly. You can tailor the meals for food allergies and preferences. This resource would be particularly helpful if you are just starting out or if you are not a person who enjoys cooking. Eating out with a lot of food restrictions can be very challenging, and learning to cook low FODMAP can take some time. Modifyhealth also offers access to dieticians to help you navigate exclusion, reintroduction, and personalization of the diet.

Lastly I want to highlight Fody Foods (https://www.fodyfoods.com). They do certified low FODMAP condiments. Condiments have been particularly hard for me to find since most have high fructose corn syrup in them. This company makes salad dressings, BBQ sauce, salsa, pasta sauce, marinades, garlic and onion infused olive oils, spice blends, and some snacks. Several of my local grocery stores carry a handful of their products and you can also order online from their website.

Personally I like to cook and I have been doing this diet for several years now, so I mostly just use the app food guide on a regular basis. But these other resources would have been super helpful early on in my experience with this diet and I’m so glad they exist. For people just starting out or for those of us who are already established with this diet to have as a back-up or additional resource. I hope this blog post reaches some people who are looking for help and support with IBS and a low FODMAP diet. These types of resources are what I wish I had when I was first diagnosed.