• Proper nutrition for irritable bowel syndrome – Fodmap

    Posted on November 12, 2021 by in Digestion
    Which fruit contain a lot of FODMAPs

    Which fruits contain a lot of FODMAPs? 
    © iStock / Halfpoint

    The FODMAP diet is designed to help people with irritable bowel syndrome. Here you find out what the term means, which foods contain a lot of FODMAPs and what to look out for in this type of diet.

    The new magic word for intestinal patients is called Fodmap. Behind the sleek abbreviation are the bulky names of certain nutrients that medical professionals blame for so many digestive ailments: fermenting oligosaccharides, disaccharides, monosaccharides and polyols. Such carbohydrates and sugar alcohols are contained in many foods and are basically not a problem at all. In healthy people, these components are almost completely broken down and absorbed in the small intestine.

    It is different for people who suffer from an intestinal disease. With them, it can happen that some Fodmaps are not broken down completely and reach the large intestine. There they either draw water into the intestine due to their water-binding ability, or they are broken down by bacteria with the formation of gases. The result can be uncomfortable gas, diarrhea or unexplained abdominal pain. Sometimes patients also report heartburn when the pressure from the gases becomes so strong that the stomach acid pushes upwards and irritates the esophagus.

    Not the same as lactose or gluten intolerance

    Lactose-containing dairy products and some cereal components are said to cause problems. The long-known lactose intolerance also causes similar complaints. However, this is due to a deficiency in the enzyme lactase and can be diagnosed by a simple test.

    Gluten intolerance, a reaction of the immune system to the smallest amounts of gluten in many types of grain, has other causes than sensitivity to Fodmaps, which usually only lead to unpleasant symptoms when larger amounts are consumed. Because numerous types of fruit such as apple, pear or mango contain a lot of fructose, they too are often responsible for complaints.

    However, it remains undisputed that apples are part of a healthy and balanced diet. But as is so often the case here, too, it depends on the amount: While a healthy person only has to expect gas or diarrhea after eating four, five or six apples, an irritable bowel patient could experience symptoms with just one or two apples. Everyone has their own individual tolerance limits for certain foods.

    Particularly critical: fructose

    The fact that the food industry is increasingly adding fructose to its products or using modified sugar beet syrup for sweetening increases the problem. Fructose per se is not the problem in this case, but the weak intestines of the patients. Around 10 to 15 percent of the western population suffer from irritable bowel syndrome. It is characterized by unspecific intestinal complaints and is diagnosed only by excluding other diseases. Several studies in recent years have shown that changing your diet in favour of foods with low Fodmap contents can have a positive effect on the symptoms. Also in patients with inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, an appropriate diet could have a positive effect on the symptoms.

    Discuss diet changes with your practitioner

    The diet is based on countless nutritional protocols that have been evaluated by Australian doctors for problematic food components. It is a new concept that has not yet been definitively proven. But there is not much you can do wrong with compliance. However,  it might not make the severe intestinal inflammation go away.

    Avoid foods high in FODMAP

    While lactose or fructose intolerance and gluten intolerance can be clearly diagnosed by a doctor, this is not so easy with sensitivity to fermentable saccharides and polyols: it can actually only be determined by trial and error. To do this, it is necessary to remove all foods with a high Fodmap content from the menu for about four to six weeks. If the symptoms subside, a corresponding sensitivity is very likely. Step by step, the patient can then add those foods to the menu that are important to him, one at a time. If there are no new symptoms, he can increase the portion or try another food.

    Eat wheat-free as a test

    Often it is also sufficient to eat a wheat-free diet first, because then you automatically consume less problematic oligosaccharides. In addition, it is easier for laypeople to follow a wheat-free diet.
    And lactose-free milk and gluten-free cereal products are now available everywhere.

    There are also many low-fodmap alternatives for fruit and vegetables.
    You can get extensive tables to help you find suitable foods. The tables should only serve as a rough guide, because the information sometimes differs. Depending on the degree of ripeness, some types of fruit contain more or less fermenting carbohydrates. If this sounds too complicated for you then it can be beneficial to have support from an experienced nutritionist.

    What are Fodmaps?

    The abbreviation stands for nutrients that are not sufficiently broken down in the small intestine and can therefore cause discomfort. Foods with low fodmap content put less strain on the intestines. Critical substances are:

    Large sugar compounds like fructans and galactans. e.g. Paprika contains little of it.

    double sugars, which also include lactose (milk sugar). There is little lactose left in matured cheese.

    Problematic: the simple sugar fructose (fruit sugar). In rhubarb, the content is rather low.

    Polyhydric alcohols such as the sweeteners sorbitol or xylitol. Grapes are poor in natural polyols.

    Low FODMAP foods

    Bananas, grapefruit, raspberries, melons, kiwis, grapes, citrus fruit, Chinese cabbage, carrots, lettuce, pumpkins, corn, peppers, cucumbers, celery, tomatoes, zucchini, ripened cheese, lactose-free dairy products, brie, feta, spelled bread, gluten-free cereals, glucose (Grape sugar), sucrose (table sugar)

    Foods high in FODMAP

    Apples, pears, cherries, mangoes, apricots, peaches, plums, watermelons, artichokes, cauliflower, broccoli , peas , legumes (chickpeas , lentils, red beans), garlic , mushrooms, sugar snap peas , onions, buttermilk, cream cheese, milk, Ricotta, biscuits, cakes, pasta, wheat and rye bread, honey, sorbitol, mannitol, xylitol, maltitol, isomalt

    Help from the pharmacy

    In the case of constipation, fiber such as psyllium or Kfibre are useful, as they regulate digestion in a gentle way.  Important: drink enough with it!

    Uzara root, Myrrh and charcoal can help against diarrhea. They should only be used for a short time (1-2 weeks).
    Other astringent herbs traditionally used for diarrhea include blackberry leaves, blackberry root bark, blueberry leaves, and red raspberry leaves. Raspberry leaves are high in tannins and, like blackberry, may relieve acute diarrhea.

    Herbal extracts from candytuft, caraway or artichoke, some of which are available individually or in different combinations, aid digestion.
    Peppermint oil in capsules is another mild alternative to help relieve irritable bowel discomfort.

    Many people find it helpful to have regular colonics when they suffer from IBS. We can also see during the session how well you digest your food.

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