Introducing A New Evidence Based Treatment for Irritable Bowel Syndrome
Over the last decade there has been some great advancements in the dietary treatment of IBS symptom management. A clinically researched restriction and reintroduction dietary approach called the low FODMAP diet originally developed at Monash University in Australia has consistently shown efficacy as a treatment for IBS.
Generally speaking 60-70% (or 3 out of 4) of people with IBS experience a significant improvement in symptoms especially bloating and flatulence. Individuals with IBS-D (irritable bowel syndrome with diarrhoea predominant) or IBS-M (mixed symptoms of diarrhoea and constipation) often experience more benefit from a low FODMAP diet. The vast majority of symptom improvements are seen within 4 weeks on a low FODMAP diet. While some individuals will not experience any improvement and should seek further treatment options.
In the UK Kings College London have been the pioneers of research on the low FODMAP diet. They also provide training and information for registered dietitians as well as researching the diet.
What is the low FODMAP diet?
Fermentable, Oligo-saccharides, Di-saccharides, Mono-saccharides and PolyolS (FODMAPs) are short chain carbohydrates (e.g. fructans, galacto-oligosaccharides, polyols, fructose and lactose) that are poorly absorbed in the small intestine. Ingestion of FODMAPs leads to alterations in fluid content and bacterial fermentation in the colon triggering functional gut symptoms in susceptible individuals. Removing FODMAPs from the diet is effective in improving symptoms of people with functional gut disorders like IBS. The diet is effective when FODMAP-trained dietitians provide dietary advice. Information taken from http://www.kcl.ac.uk/medicine/research/divisions/dns/projects/fodmaps/index.aspx [Accessed July 2016]
The effect of FODMAPs on IBS symptoms
There is a fantastic research paper by the team at King’s College London which describes the mechanisms by which FODMAPs trigger IBS symptoms and the image below is found in this paper. Unfortunately it is not open access so if you cannot read the paper then take a look at the video below produced by Monash which gives provides an explanation.
Image found in the paper ‘Mechanisms and efficacy of dietary FODMAP restriction in IBS ‘ (see here)
Lists of Foods high and low in FODMAPs
The most reliable source for lists of foods high or low in FODMAPs is found on the ‘Monash University Low FODMAP App‘ which is available for smartphones and tablets. It is the data source that all other lists of FODMAP foods take their information from and the app is constantly updated with new foods. Try not to completely rely on lists found on internet sites as they will often have inaccuracies and out of date information. The low FODMAP app by Monash is a valuable resource and worth the small monetary investment. Certainly if you do not have access to a dietitian to help you with the diet then this resource will be one of your most valuable.
How long does it take to complete the low FODMAP diet?
The low FODMAP diet is a 3 phase dietary treatment. Phase one is the low FODMAP restriction diet which you should follow for 4 weeks. Phase two is the reintroduction phase which takes about 10 weeks to complete and the third phase is the long term self management of IBS symptoms using a modified low FODMAP diet. You can read more about a modified low FODMAP diet here. It is important to complete phases one and two under the guidance of a dietitian. If you are unable to do this then ensure you have the best available resources to help with these two phases:
- For the low FODMAP restriction diet: Purchase the Monash University low FODMAP App or the FoodMeastro ‘FODMAP by FM’ app
- For the reintroduction phase purchase the book ‘Re-challenging and Reintroducing FODMAPs A self-help guide to the entire reintroduction phase of the low FODMAP diet‘ by registered dietitian Lee Martin or the FoodMeastro ‘FODMAP by FM’ app
- The Low FODMAP diet starts today!
- Reintroducing FODMAPs
- End of Week 2 on the Low FODMAP Diet
- I’m now researching FODMAPs at Kings College London!
Want more information on the low FODMAP diet and IBS? Click here for the latest changes and important updates.
We are currently travelling around the world and plan to bring you‘Around The World In 80 Low FODMAP Dishes’ – a collection of the best low FODMAP foods and recipes as we travel the globe. See more on our low FODMAP diet travel section.
Good news! The first ever book dedicated to reintroducing FODMAPs is now available to purchase on Amazon Kindle. The book is titled ‘Re-challenging and Reintroducing FODMAPs – A self-help guide to the entire reintroduction phase of the low FODMAP diet’. Click on the logo for more details.