Irritable Bowel Syndrome (IBS)

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.

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