FODMAPS, Part 1

Spoiler alert: there will be poop talk in this post.

Let’s start with WHAT are FODMAPS.

F-Fermentable

O-Oligo-saccharides {fructans, & galacto-oligosaccharies- GOS}

D-Di-saccharides {lactose/milk sugar}

M-Monosaccharides {excess fructose}

A-And (very technical here)

P-Polyols {sugar alcohols such as mannitol and sorbitol}

So think of it like Jethro Tull, it’s the name of the band – not just one person (or thing).

FODMAPs are a group of small chain carbohydrates that are commonly malabsorbed in the small intestine. Malabsorption can occur in anyone, but this presents a further issue for those diagnosed with IBS, IBD, and other GI issues.

Common symptoms of malabsorption of these FODMAPS are gas, bloating, pain, changes in bowel habits (so sudden need to go, or prolonged wait to go).

I’ve had ongoing GI issues since 2012, upon starting my first “big girl job” and starting to run. Granted if you knew me in high school and college you would know that my diet was not the greatest, so maybe that was some foreshadowing. I joke that I should not be shocked this happened.

After 6 years of on and off acid reflux meds and trying different things with my diet I finally saw a new GI, who suggested a FODMAP elimination, and by “suggested” it was this or a colonoscopy.

I chose to try and go no/low FODMAP.

I have a little experience with this, as it is something that I put Pat on a few years ago, in an attempt to help alleviate some of his symptoms at the time. However, my specialty as a dietitian is not “GI”, I am a Certified Diabetes Educator, and I also travel a lot/don’t work in a traditional office environment. That being said this elimination diet is VERY challenging.

I’m glad I did it, even if I did cut a few corners, because for the first time in a long time I feel better. Like, way better, but I’m also learning that my symptoms go a bit deeper than I thought they did (we don’t need to elaborate any more on my symptoms).

So why do FODMAPSs make people with IBS feel gross?

FODMAPS are tiny carbohydrates, because of this, when they are broken down after digestion they can pull water into the small intestine (this can cause bloating, gas, and diarrhea), especially if an individual has a fast reflex to food entering the small intestine/leaving the stomach.

In addition to this we all have helpful bacteria in our gut microbiome, this is a good thing – these bacteria help us digest our food, help create vitamins, and help keep our immune system in tip-top shape.

However, FODMAPs are great little snack treats for these microbes and when they ferment FODMAPs they produce gas, and the gas stretches your small intestine – so this contributes to bloating, cramping, gas, and diarrhea or constipation – basically a buffet of unpleasant symptoms. Combine this with acid reflux, and I feel like I have been at the mercy of my GI tract for a long time.

I’ll wrap this particular post up with a few things:

1) Do not self diagnose, please learn from my mistakes, I should have seen a GI long before I did.

2) Do not self jump into this diet, please do it with the guidance of a Registered Dietitian, and GI specialist. I also had blood tests, and had to give a stool sample (that was VERY humbling) to rule out celiac and a few other things that made my doctor give me the green light to do this in lieu of a colonoscopy

3) Even as a dietitian I needed help. Kate Scarlata’s website is a fantastic resource, and I recommend it if you are a practitioner or going through the low elimination/reintroduction phase – it’s a great resource. I also bugged my friends who are in private practice/specialize in GI with tons of questions. Bottom line it’s a difficult diet.

I call it a diet because that is what it is, it was a pattern of eating I followed for a specific period of time to achieve a desirable and therapeutic effect.

In my next post I’ll dive deeper into what foods contain FODMAPs and some things I learned on my way to a healthier gut.

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