Finding Relief from Irritable Bowel Syndrome: Say Hello to FODMAPs!

A dietary approach to help manage IBS shows great promise 

This is a guest blog post.


Irritable bowel syndrome (IBS) is defined as disorder that consists of abdominal pain, cramps, bloating, changes in bowel movements, and other symptoms (1). Unlike inflammatory bowel diseases, such as Crohn’s disease, IBS does not result from abnormal structure of the bowels (1). The actual causes of IBS remain unclear, however a possible trigger may be an infection of the intestines, called post-infectious IBS (1). One theory is that sufferers of IBS may have a particularly sensitive colon that is reactive to certain foods and stress, and that the immune system may also be involved (2). IBS can occur at any age, but usually begins in the teens or early adulthood, and is twice as common in women as in men (1). It is said that one in six people in the U.S. experience symptoms of IBS, and it is the most common intestinal problem for patients who are referred to a gastroenterologist (1). Because this disorder causes patients to experience discomfort when eating certain foods, it can eventually breed anxiety from constant worry of what effects these foods will have on their symptoms.


Symptoms

The major symptoms of IBS include abdominal pain, bloating, gas, and fullness. Symptoms may last three days a month for at least three months . These symptoms range from mild to severe, depending on the patient (1).

People with IBS may also switch between constipation (difficulty with bowel movements), or diarrhea (loose or watery stool) (2). Some may only have constipation, while others may only experience diarrhea (1). People sometimes find that their symptoms may subside for a few months and then return, while others have worsening symptoms over time (2).


The FODMAPs Diet

While there is no treatment for IBS, patients can learn to maintain their symptoms by following specific dietary guidelines, including those presented in the FODMAPs diet. FODMAP stands for Fermentable, Oglio-, Di-, and Mono-saccharides, and Polyols (3). The theory behind the FODMAPs diet is that consumption of these carbohydrates increases the volume of liquid and gas in the small and large intestines, leading to bloating and abdominal pain (3). Therefore, it is proposed that a diet low in FODMAPs should decrease these symptoms. FODMAPs include lactose, fructose, fructans, galactans, and sugar alcohols, which are found in many common foods, including:



• Animal dairy products, such as cow’s and goat’s milk, cheese, and yogurt.

• Fruits, particularly apples, pears, watermelon, mangoes, dried fruit, and fruit juices (3).

• Legumes, including chickpeas, lentils, black-eyed peas, broccoli, and soy products (4).

• Wheat products, including wheat and rye breads, cereals, and granola bars containing wheat.

• Sugar-free gums, mints, lozenges, and medications (4).

• Ketchup, barbeque sauce, honey, agave nectar, and other condiments and artificial sweeteners (4).

• Sugary drinks, like soda, and alcohol (4).


While the FODMAPs diet might call for avoiding many foods, there are still foods that are allowed. These include:



• Lactose-free milk (including rice milk and almond milk), cottage cheese, ice cream and sorbet; cheddar, Swiss, Parmesan, and mozzarella cheeses (4).

• Fruits such as bananas, berries, honeydew melon, oranges, kiwi, grapefruit, grapes, and passionfruit (4).

• All-natural sweeteners, including sugar and natural maple syrup (4).

• Vegetables, including bell peppers, carrots, butter lettuce, celery, corn, eggplant, bok choy, tomatoes, potatoes, and spinach (4).

• Gluten-free breads and cereals, oats, rice and corn pasta, corn tortillas, rice cakes, and potato and tortilla chips (one should check labels on these products for any sweeteners or additives, such as honey or agave nectar) (3, 4).


These guidelines may vary among IBS patients. Some may be able to tolerate some foods that are prohibited by the FODMAPs diet, while others might be able to consume several without having any major discomfort.


Other dietary recommendations for those with IBS include drinking at least six to eight glasses of water per day, especially if they suffer from diarrhea (2). It is also recommended that patients do not consume large meals, as this can cause cramps and bloating (2). Instead, patients may be advised to eat smaller meals throughout the day, or smaller portions (2). Increasing fiber in the diet can also help by reducing constipation (1).


Other Relief Methods for IBS

Along with dietary changes, other methods to relieve symptoms of IBS include:



Prescribed medications

• Laxatives to relieve any constipation, or medicines to decrease diarrhea, such as diphenoxylate and atropine (Lomotil) or loperamide (Imodium) (2).

• Antispasmodic, which helps control colon muscle spasms and reduce abdominal pain (2).

• Antidepressants



Stress reduction activities

• Meditation

• Regular exercise, such as walking.

• Counseling and support

• Adequate sleep.



Resources:



1. Irritable bowel syndrome: Spastic colon; Irritable colon; Mucous colitis; Spastic colitis (Last reviewed: July 22, 2011). Retrieved May 27, 2012 from PubMed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001292/



2. Irritable bowel syndrome (September 2007). Retrieved May 27, 2012 from National Digestive Diseases Information Clearinghouse (NDDIC): http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/#symptoms



3. Bradley Bolen, Barbara. Foods on the FODMAP Diet: High FODMAP Foods and Low FODMAP Foods (Updated March 16, 2012). Retrieved May 27, 2012 from About.com: http://ibs.about.com/od/ibsfood/a/The-FODMAP-Diet.htm



4. Scarlata, Kate. The FODMAPs Approach- Minimize Consumption of Fermentable Carbs to Manage Functional Gut Disorder Symptoms. Today’s Dietitian. Vol. 12 No. 8 Page 30. May 16, 2012.



About the Author:

Lauren Wisnowski is a senior Wellness Management major at SUNY Oswego and is from Rochester, NY. Having a vested interest in nutrition and wellness, she aspires to become a registered dietitian in the future. She enjoys exercising, especially running, as well as reading, writing, and spending time with her friends and family. Her hobbies also include quoting movie lines and watching Nickelodeon re-runs from the '90s.