Back when I went through pharmacy school, medical school, and then residency, irritable bowel syndrome was very mysterious. Vague. Did it really exist? Were these patients just neurotic? Over-anxious? We never had much to offer irritable bowel patients. Some fiber. Some Bentyl. Now, it seems the leading irritable bowel doctors are using…drumroll, please…nutritional intervention! I am so happy I learned about food! I mean, I eat it every day, but I had NO idea how it seriously plays a role in my day-to-day function, feeling, and well-being!
For irritable bowel syndrome, researchers discovered that these common food components, called FODMAPS, were messing with some people’s GI tracts! FODMAP foods were removed from patients’ diets, and something like 75% of patients had significant improvement. It wasn’t in their heads after all. How nice. We actually have to believe our patients. Hmmm.
If you Google “FODMAPS”, you’ll find dozens of most excellent resources about it. I kept landing on FODMAP posts when I was trying to figure out my extensive bloating and my new-found classic irritable bowel syndrome symptoms. FODMAP intolerance symptoms include: stomach pains, bloating, gas, diarrhea, and even constipation. FODMAP containing foods are VERY common foods, particularly on a whole foods diet! Things like honey, broccoli, asparagus, dates, and apples have significant FODMAP levels.
When I asked my GI specialist about FODMAPS causing my problem, she kind of seemed scornful (probably my imagination); I was visiting her for chronic constipation. She said, “No. FODMAPS usually cause diarrhea.” Well, that’s not what the internet says, dang it! And now, about 7-8 months after my visit with her, I’m having irritable bowel syndrome symptoms after too many dates, too much avocado, an apple, broccoli, cauliflower. Classic irritable bowel symptoms! I could get tested, and I still might. However, elimination and introduction repeatedly seem to have proved the FODMAP matter in my mind. I’m wondering, if I have the courage, if removing FODMAPS will further help my GI tract.
FODMAPS is an acronym. Each letter stands for the first letter of a nice, long word:
F=Fermentable When the carbohydrates/sugars listed below make it undigested further down the intestine than they should, bacteria ferment them. Think bubbles and stretch. And bloating and cramps. And diarrhea.
O=Oligosaccharides (fructans and galactans) Bigger sugars/carbohydrates found in many fruits, vegetables, and legumes. Asparagus, onions, garlic, lentils, and more!
D=Disaccharides (lactose) Two sugars that are held together (“di”) to make lactose are not cleaved the way they need to be for absorption. Found in milk.
M=Monosaccharides (fructose) The small intestine just isn’t getting fructose transported across the wall like it should. Found in honey, apples, watermelon, among many others.
P=Polyols These are kinds of sugar alcohols. Not like the alcohol in wine or beer. Found in apples, avocados, some of the sugar replacements like xylitol (could explain some stomach turning after using Tom’s toothpaste), among other sources.
S=from the s in polyols Or is it to just make it plural?
These substances are all carbohydrates, some are specifically types of sugar, but not all. They are found in very common foods. If a person’s body doesn’t break them down appropriately and completely like they should, or doesn’t absorb them properly, they travel further down the small intestine and into the large intestine; all the time bacteria is working on them, fermenting them. Bloating, gas, cramps, diarrhea, foul smelling gas, diarrhea, and even constipation will result.
An individual will have different abilities to absorb different amounts of each FODMAP. A person may be sensitive to one part of the”FODMAP” equation but not the others. For example, a person may tolerate honey great but not avocados. The treatment is to remove FODMAPS for awhile.
GAPS, SCD, Paleo, Whole30, Primal, a whole foods diet, and others will rely heavily on foods that may exacerbate a person’s FODMAP sensitivity. I do the GAPS diet, and I am putting together a list for myself of the vegetables that are both GAPs and FODMAP approved. It is not only vegetables that cause problems, but I lean heavily on vegetables rather than fruits/grains/legumes, so I am interested in those right now. For those interested, check back!
Food has taken this completely sane, practical person and turned her culinary-delights and medical world upside down. Upside down. Please don’t use any information on this blog for self-diagnosis and treatment. Find a healthcare provider you trust to discuss things with.
Food counts. It’s not just about your weight. It’s about your function. I would have laughed at you in the face if you suggested a year and a half ago that eggs made me feel blue. Loon. That’s what you’d have been. Eggs do not make people feel sad and irritable. No. They don’t make most people feel that way. But they do make me feel that way. All I’m saying is that we have to be aware. Food is a drug. Take only that which you need and benefits you.
Posts in the draft bin: FODMAP/GAPS vegetable list, GAPS testimonial regarding siezures