Daliah Wachs, MD, FAAFP
Bloating, diarrhea, constipation, gas, abdominal pain, fear of eating certain foods……this is what an Irritable Bowel Syndrome (IBS) patient deals with all too often. 10- 15% of Americans suffer with IBS and there is no cure. We try to treat IBS with a variety of options: increasing fiber, probiotics, antibiotics, exercise, fluids, threapy, antianxiety meds, antidepressants…and some newer medications are now available, but the common thread of treatment is avoiding certain foods. Some of us know our trigger foods, some of us don’t. Hence, enters FODMAPS.
FODMAPS stands for fermentable oligo-, di-, and monosaccharides and polyols. Not that this needs any explaining, but these are groups of carbohydrates and sugars in foods and additives that are fermented, or broken down by bacteria. When a bacteria breaks down sugar, it produces gas. In addition, these carbohydrates don’t digest well in the small intestine (also causing gas, pain and bloating) and their osmotic effects draw in lots of water so bowel motility changes, causing diarrhea and/or constipation.
Gastroenterologists have long been recommending low FODMAP diets for patients with IBS and a recent study published in the American Journal of Gastroenterology cites IBS symptoms improved after just two weeks of a low FODMAP diet.
So what are high and low FODMAP foods?
As for high (the ones you want to AVOID), the list is huge, encompassing many types fruits, beans, dairy, garlic, onions, condiments, sweeteners, beer, and yogurt just to name a few.
High (need to avoid in IBS):
Fruits (high in fructose): apples, pears, watermelon, dried fruit, avocado, raisins
Dairy (high in lactose): cream cheese, yogurt, ice cream, milk
Vegetables: broccoli, cauliflower, onions, mushrooms, lima beans (fine by me)
Grains: cake, wheat pasta, egg noodles, croissants, bran
Food additives: sugar substitutes that end in “ol”, pesto sauce, sugarless gum & candy
Alcohol: beer, rum
IBS Diet Fodmaps Foods | image by http://www.myhealthmedicalgroup.com
A Low FODMAP diet could consist of foods from the same groups as above, but it also allows meat, fish, nuts, coffee, cheese, herbs and some types of alcohol.
Low (may improve IBS)
Fruits: bananas, orange, grape, strawberry, blueberry, cantaloupe, kiwi
Dairy: lactose free diary, soy milk, hard cheese (brie, cheddar, swiss)
Vegetables: carrots, celery, squash, eggplant, spinach, zucchini
Grains: rice, oats, polenta, buckwheat, seeds, many types of nuts,gluten free
Food additives: some sugar substitutes such as aspartame, syrup, sugar, mustard
Alcohol (in moderation): vodka, gin, whiskey
Confused? A comprehensive list is included here by ibsdiets.org.
We forget that anxiety can trigger IBS. If trying to dissect out High FODMAP foods, from Low FODMAP foods will trigger anxiety, resulting in IBS, I’ll just eat a gluten-free strawberry shortcake, or a lactose free banana split and call it a day.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician