Irritable bowel syndrome (IBS) is a condition of the gastro-intestinal tract that causes recurrent symptoms of bloating, abdominal pain, constipation and diarrhoea. IBS surprisingly affects 1 in 7 adults.
The condition is regularly associated with stress, anxiety, altered food habits, and other environmental factors. It is often unclear however, whether the environmental factors are causing the symptoms, or whether the symptoms are causing stress and altered food habits.
Treatment for this distressing condition which causes the recurring discomfort, and leads to reduced quality of life in some cases, is often essentially to avoid any ‘problem’ foods. The downside to this is some people end up omitting whole food groups in fear of symptoms returning. This can result in nutrient deficiencies if left for too long.
Stress reduction has also successfully been used in the past to help manage symptoms.
Researchers at Monash University have conducted short and long-term studies, finding that dietary intervention involving a low FODMAP diet is the most effective strategy for IBS symptom management.
FODMAPs (fermentable, oligosaccharides, disaccharides, monosaccharides and polyols) are poorly absorbed carbohydrates that are found in many different foods, and sometimes in very small amounts.
The low FODMAP diet usually involves eliminating foods containing any of these carbohydrates, then gradually reintroducing in small amounts to test and establish tolerance levels.
Examples of low and high FODMAP foods
|Food Category||High FODMAP foods||Low FODMAP food alternatives|
|Vegetables||Asparagus, artichokes, onions(all), leek bulb, garlic, legumes/pulses, sugar snap peas, onion and garlic salts, beetroot, Savoy cabbage, celery, sweet corn||Alfalfa, bean sprouts, green beans, bok choy, capsicum (bell pepper), carrot, chives, fresh herbs, choy sum, cucumber, lettuce, tomato, zucchini.|
|Fruits||Apples, pears, mango, nashi pears, watermelon, nectarines, peaches, plums||Banana, orange, mandarin, grapes, melon|
|Milk and dairy||Cow’s milk, yoghurt, soft cheese, cream, custard, ice cream||Lactose-free milk, lactose-free yoghurts, hard cheese|
|Protein sources||Legumes/pulses||Meats, fish, chicken, Tofu, tempeh|
|Breads and cereal||Rye, wheat-containing breads, wheat-based cereals with dried fruit, wheat pasta||Gluten-free bread and sourdough spelt bread, rice bubbles, oats, gluten-free pasta, rice, quinoa|
|Biscuits (cookies) and snacks||Rye crackers, wheat-based biscuits||Gluten-free biscuits, rice cakes, corn thins|
|Nuts and seeds||Cashews, pistachios||Almonds (<10 nuts), pumpkin seeds|
TABLE from Monash University: http://www.med.monash.edu/cecs/gastro/fodmap/low-high.html
If you think you may be suffering from IBS, it is important to first see your health care provider to investigate your symptoms and rule out other gastrointestinal conditions such as Crohn’s disease and Coeliac disease.
An Accredited Practising Dietitian (see www.daa.asn.au) can then help plan and establish a low FODMAP diet specific to your individual needs.