Today, I wanted to chat about FODMAP's. For me, understanding what FODMAP's are and how they affect my digestion has been key in improving gut-health while also significantly reducing my stomach pain/bloating. Now let's be real, bloating is certainly normal, natural and a part of life. However, I had such painful bloating every single day that most days I resigned to laying in bed until I felt better. AKA NOT normal. While some of these symptoms were certainly SIBO-related (which I was ultimately diagnosed and treated for), some of my severe bloating was also a result of high-FODMAP foods that I was consuming. You may be thinking...FODMAP? Huh?
So, first of all, what does the abbreviation "FODMAP" stand for, and what the heck are they? FODMAPS are a kind of carbohydrate that is poorly absorbed (for some people) in the small intestine. FODMAP stands for the following:
- Fermentable (yum)
- Oligosaccharides (fructans -- examples include garlic and onion)
- Disaccharides (lactose -- examples include soft cheeses, cottage cheese)
- Monosaccharides (fructose -- examples are honey, apples, etc.)
- Polyols (sugar alcohols -- examples are artificial sweeteners, apples, watermelon)
How do I know if I need to eliminate FODMAP's?: For anyone out there who has been diagnosed with IBS or SIBO, I've would recommend giving low-FODMAP a try. I personally found that eating a low FODMAP diet to be tremendously helpful in reducing my symptoms and maintaining structure in my day to day life. If you are at the point where things feel a little bit out of control, I don't think you have much to lose giving the elimination phase a go. I also personally feel strongly that if you've had stomach pain for a long period of time and have received a diagnosis of IBS in the past, get tested for SIBO (SIBO post).
What's the elimination process? What I've been previously advised is a 2-6 week elimination diet where you eliminate ALL FODMAP's. This period of time can be more/less depending on your symptoms, but you do want to make sure that you cut out FODMAP's long enough to alleviate all of your symptoms, prior to the reintroduction phase. Then, after this period, you pick a group of FODMAP's and gradually add a specific high-FODMAP food back in. You increase the quantity of this food each day, until you ultimately experience discomfort; thus, learning your threshold for that particular FODMAP. Definitely do your research prior to reintroduction, because there aren't any shortcuts, and that's something that I learned the wrong way.
How do I know what I can/can't eat? What's high FODMAP and low FODMAP? I've included the list below (directly from Monash), as well as additional links from Kate Scarlata that provide a good detail of what foods you should be avoiding. Honestly, the diet isn't TOO restrictive, especially once you feel the awesome side effects.
My thoughts/experiences with the low-FODMAP diet: I think that my first experience with trying the low FODMAP elimination diet was somewhat blurred by the fact that I also had SIBO at the time, which was significantly contributing to my symptoms. So, in retrospect, I think that I should probably go back and re-do the elimination period at some point to get a true baseline of my tolerance for certain groups. However, I still learned the *key* fact that I cannot tolerate onions and garlic. At all. So, I've cut out both completely from my diet (other than garlic-infused olive oil which doesn't have the level of FODMAP's that raw or cooked garlic does). I've also eliminated dairy, because I am technically lactose intolerant. I feel a significant difference from just these three changes. I tend to eat gluten free, but also eat bread from time to time (sourdough bread with real butter is just <3) and don't notice a huge difference personally from that. I've slowly started adding back roasted veggies in smaller quantities, and I am handling them (knock on wood) just fine. Some other things that I know always upset my system are gum (sorbitol), high-fiber bread products (inulin), and watermelon. I'm always learning and refining though, and it's a continual process. I also want to highlight that a low-FODMAP diet is never meant to be a permanent diet, but rather help you hone in on specific foods that give you trouble and reduce the quantity you are eating/eliminate them altogether (garlic and onions for me!). And the major win I've noticed is that when I'm conscious of these particular triggers, I can (and always will) have days where I slip or just go for the burger, and I'm not back to square one with severe pain/bloating.
Other recommendations: Some other things that I've tried that have helped my stomach are "Natural Calm" which is basically a powder magnesium supplement that tastes delicious and keeps everything regular. I've also taken Iberogast, which is an herbal supplement that I put into water (or whatever beverage I happen to be drinking). Iberogast relaxes stomach muscles relieving cramps, bloating and feelings of pressure, and I appreciate that it's herbal and not a pill I need to pop each time I have symptoms.
In summary, to anyone out there who is struggling with these kind of issues - I'd give low-FODMAP a go and see how you feel. You don't have much to lose if you are armed with a grocery list and have the motivation to take it on for a couple of weeks! I find that when I loosely follow these guidelines, my stomach is totally fine when I occasionally eat a Philly cheesesteak, and that's what makes it worth it to me.
Has anyone else tried the low-FODMAP diet? Any tips/tricks, or thoughts to share? Would love you hear!
Kate Scarlata FODMAP Resources:
Monash University FODMAP Resources (note - they also have an awesome iPhone app that you can take on the go grocery shopping):