IBS is certainly difficult and challenging to live with . Sometimes it can have a negative impact on someones different aspects of life. Coping with pain, managing meals, bathroom issues, social life and family life all get affected in a way or another. What is required is some adjustments to your daily routine, meal planning and prioritizing needs and self care.
What is IBS?
IBS : Irritable Bowel Syndrome is one of a group of conditions called Functional gastrointestinal disorders, which is a very common gut disorder. Functional means that they cause disturbances in the FUNCTION of the gut but don't have any physical features such as ulcers , inflammation, lumps or abnormal blood tests.
Many people with food allergies don't have IBS. Food hypersensitivity can be an underlying problem , but the symptoms of IBS are most commonly triggered by a food intolerance.
Before reaching out to food/diet alternatives, its very important to get diagnosed by a medical professional. As a health Coach I cant give precise guidance unless you have been evaluated by a doctor.
Doctors usually look for red flags for example blood in the stool, weight loss, fever, family history and demand further investigation such as blood test and endoscopic examinations if necessary. If all those tests reveal no cause for your symptoms, then you will be diagnosed with IBS.
What contributes to the development of IBS?
- Genetic factors : studies have shown that genes play a role in IBS.
- Gut infections: some people develop IBS after being infected with a germ ( Post-infectious IBS) which causes mild inflammation in the gut and anti inflammatory drugs dont work much.
- stress: Nerve signals from the gut are interpreted in the brain which contribute to IBS.
- Abnormal balance of gut bacteria such as : SIBO: small intestinal bacterial overgrowth which is the growth of too many bacteria in the small bowel .
The Low-FODMAP Diet
1. Food intolerance
Food intolerance does not involve the immune system like food allergies. Food intolerances are the most common trigger for gut symptoms: they induce bowel distention by drawing in more fluid fermenting bowel bacteria, and they respond to foods that contain high levels of bio active substances & chemicals such as caffeine, colorings and preservatives. Those are indigestible sugars that are called FODMAPS:
Fermentable: rapidly broken down by bacteria in the bowel
Oligosaccharides: Fructans and galacto-oligosaccharides
And Polyols: sugar alcohol such as Sorbitol, mannitol, xylitol
FODMAPS cause symptoms of IBS because they are poorly absorbed in the small bowel, they cannot be broken down or they are slow to be absorbed, they force water into the gastrointestinal tract so this extra fluid causes diarrhea and gut disturbances.
High Fructan Foods to avoid:
- Wheat based products
- Fennel tea
High Lactose foods to avoid:
- Cows Milk ( whole and low fat)
- Ice cream, dairy based products, sweetened condensed milk
- Full fat yogurt,
- Soft cheeses such as cottage, creme fraiche, ricotta.
High fructose & Polyol foods to avoid:
- Fruits such as apples, cherries, figs, mangoes, pears, blackberries, prunes
- Vegetables such as asparagus, artichokes, peas , cauliflower, mushrooms
- sweeteners such as agave nectar, high fructose corn syrup, honey, fruit juice concentrate
- All DIET, SUGAR FREE or LOW CARB labelled foods such as gums, mints, candy
- Additives such as sorbitol, mannitol, maltitol, Xylitol, ismomalt .
What can i eat?
Here's a list of of the low lactose , fructose and polyol foods:
- Lactose free yogurts
- Hard cheese such as brie, blue, cheddar, emmental, feta, gruyere
- Avocados, bananas, cranberries, grapefruit, kiwi, oranges, papaya, strawberries, tomatoes,melon, lemon, lime, raspberries
- Sweeteners such as maple syrup, molasses, peanut butter
You should eat no more than one serving of fruits per meal ( one cup of cut up fruit such as an orange or banana) You can eat many fruits servings a day but allow 2 to 3 hours between each serving.
Fats and oils don't contain FODMAPs, same for animal based foods such as meat, fish, chicken, and eggs. plant based protein foods such as legumes do have FODMAPS so its important to follow the guidelines.
Avoid eating wheat , rye and barley in large quantities. remember moderation is key! if you have had a food intolerance test you should be able to know whether you are intolerant to wheat and rye products. Alternatives to wheat and other FODMAPS are:
- Gluten free bread and pasta
- wheat free fruit muesli
- rice flakes
- Chia seeds
- flowerless cakes
- wild rice
- buckwheat soba noodles
What can I snack on?
Snacking between meal is very important for IBS sufferers. Here are a few snack ideas:
- Fresh fruits such as banana, blueberries, cranberries, grapefruit, grapes, kiwi, passion fruit; but limit it to one piece or a small handful at a time.
- Vegetables such as carrots, bell pepper, cucumber
- Gluten free rice cakes with a suitable cheese topping
- Peanut butter, chicken, fish, eggs
- Lactose free yogurt
- Small amount of nuts excluding pistachios or cashews
Gluten free & Celiac Disease
It is not necessary to follow an entire gluten free diet, only if you have celiac disease as it helps improve the condition of the small bowel lining and gastrointestinal symptoms. People with celiac disease suffer from inflammation in the small intestine, that's why they opt for a complete gluten free diet for life. IBS is not related to injury of the bowel, So the low FODMAP is advised. Its also important to read all labels of packaged food and check for gluten, not all gluten free foods are LOWFODMAP .
Its also recommended to avoid all colors of onions , even if its present in small amounts as those are major trigger for IBS symptoms. When you are purchasing stocks, soups, chips, rice crackers read the label well and check if onions are in the ingredient list.
A low-FODMAP diet is not a gluten free diet. Gluten free foods don't contain wheat, rye, barley so they can be suitable for people on the lowFODMAP diet. However, you can still include barley ,wheat and rye in your diet but in small quantities and in moderation. On the other hand, you should note that many gluten free foods contain FODMAPs, such as apples , pears, and legumes, so make sure you are making wise decisions regarding your food choices.
How do I start?
It is recommended that you start the LowFODMAP diet by avoiding ALL FODMAPS for at least 2 months. Once your symptoms improve, you can gradually reintroduce one FODMAP at a time to see if you tolerate it. This is recommended to do along a nutritionist/health coach to track your symptoms and help you with meal plans.
You might find this very difficult or overwhelming. Some people find it hard to cope with, there is a lot you can do to help yourself:
- keep a food diary: write down your plan for the day: where are you going to be and what food will be available?
- When you start the LowFODMAP diet, keep track and write down everything that you have eliminated and how are you feeling on daily basis.
- Write down every food you gradually consume and whether it has affected you.
- Managing new food and lifestyle changes: Exercise, meditation, yoga, walk in nature, and practicing self care play a big role in feeling your best on daily basis.
If you feel overwhelmed and don't know where and how to start, need meal plans or more info please reach out to me! Also, if you live outside UAE i can coach you virtually! let me know of this read has helped you :)