What is this diet for?
It is estimated that 1 person in 7 is affected by IBS (irritable bowel syndrome or PDS in Dutch) and its various symptoms.
A team at Monash University in Australia devised the FODMAP diet as a way to reduce the symptoms of IBS for many of the people who suffer from this illness.
It is claimed that the FODMAP diet is successful in identifying triggers and reducing severity of IBS symptoms in approximately 75% of IBS sufferers who follow the diet process with the help of a dietitian or other medical professional.
It is important to note already in this post that the FODMAP diet should not be followed without medical guidance.
What are FODMAPs?
FODMAPs are a group of carbohydrates (sugars) which don’t fully digest or absorb in our intestines. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. This group of carbohydrates are found in a wide range of foods, naturally or as additives. The majority of people can eat them everyday with no issues.
People with IBS, however, can experience symptoms (including pain, gas, bloating, diarrhoea and constipation) from these sugars. This is due to problems with the the extra water and gas that are produced when FODMAPs move through our intestines. People who have IBS can be affected by the speed at which contents move through the intestines and/or by having a sensitive gut wall which is irritated by this process.
What is the FODMAP diet?
The FODMAP diet is a 3-stage process used to determine whether FODMAPs are a cause of IBS and if so, which ones create a reaction for the sufferer.
Under supervision from a dietitian, this phase takes between 2 and 6 weeks. Only foods classified as “green” / low FODMAP should be eaten during this time and any “yellow” and “red” foods should be avoided or substituted for equivalents that are low FODMAP.
This phase sees a staged re-introduction of certain types of FODMAP foods in measured quantities (whilst maintaining a low FODMAP diet overall) to determine if specific types of FODMAPs cause symptoms. This will usually take 6-8 weeks to complete.
Integration / Personalisation
With the info from the re-introduction phase, the dietitian should now be able to create a personalised diet plan which will avoid any trigger foods. They will also be able to advise on other steps to take if the FODMAP diet hasn’t been successful for the individual.
What is my experience of the low FODMAP diet?
Before the diet
I’ve struggled with IBS since I was a teenager (I’m now in my mid-30s). Whenever I’ve seen the doctor about it, I’ve been told it was due to stress, my lifestyle or just “one of those things you have to deal with”. For me, none of these seemed true or even acceptable that I just had to deal with IBS and live my life facing such frustrating issues. In 2018, I went through a really bad period for months on end and I knew I had to find a way to fight for myself and my health.
My symptoms were causing me ongoing, daily problems – having to excuse myself from business meetings due to a reaction to whatever I’d eaten for lunch, awkward moments on dates when I was having to spend long periods in the bathroom, having to ask a colleague to stop the car frequently during a long drive to visit clients, cancelling dinner with friends as I knew there was no point going out to a nice restaurant as every time I ate I was left with crippling stomach ache or worse.
Talking about toilet habits is super awkward but I had to start being quite open (and probably sometimes oversharing) about what I was going through because it was affecting every aspect of my day. I came to find that honesty was better than uncomfortable excuses and half-truths. Also, I found out that so many people around me suffer from IBS or related issues too so perhaps we should all be talking about poo more openly!
My GP (huisarts) finally recommended that I go to see a dietitian to start the FODMAP process. I’d never heard about this diet before, despite seeing a number of GPs in England and the Netherlands about my IBS over more than a decade.
The dietitian I met with was excellent. She explained what FODMAPs were, what the stages of the diet would be and how I should start the diet. She provided me with lots of written and online resources to help me too. And, she was always available on email when I had questions or anxieties about the diet between my appointments.
The first 6 weeks of eliminating all FODMAPs was really tough for me. I love food and I’ve never had to think so hard about what I could and couldn’t eat. I love going out for dinner and this became very difficult as you can’t always be sure what dishes contain. There were lots of tears and tantrums from me during this period. The only thing that pushed me to keep going was the fact that my symptoms had already noticeably reduced, even after just 2 or 3 weeks.
Just after the 6 week phase, I went on holiday to Vietnam, Cambodia and Thailand for 3 weeks. This really set me back in the process as it was too difficult to maintain a low FODMAP diet when travelling. When I returned, I had to re-start the elimination phase which was then interrupted by the Christmas period. After Christmas, I did another couple of weeks of elimination before finally feeling that I was ready to start the re-introduction schedule. This obviously delayed the whole process for me but I think it’s worth sharing as real-life doesn’t stop and, no doubt, others who go through this process might face delays too for various reasons. Don’t feel disheartened by this. It isn’t reasonable to expect normal life to be put on a complete hold.
The re-introduction phase (once I was finally able to start it) was easy to complete as I had such clear guidance from the dietitian. I followed a plan to re-introduce certain FODMAPs by measured quantities around a strict time schedule. Some re-introductions had a clear effect on me so it was easy to determine that I should avoid those FODMAP types in the longer-term. Others took time to build up before I experienced symptoms which also gave me insight into how much of those FODMAPs my body can handle before they cause me problems. I kept detailed records during this time which I gave to the dietician to produce her final recommendations and guidance for me.
More than 18 months into the process and I cannot explain how much my life has changed due to this diet. Of course, I still face some IBS episodes but they have become very infrequent and much less severe than they ever were.
I still maintain a low FODMAP diet when it comes to the FODMAP categories that caused me problems but am more conscious now that when I do stray from that, I understand what my intolerance levels are of specific FODMAPs and can manage those more easily. I also have supplements that I can take if I am going out for dinner which help neutralise the FODMAPs which cause me the most issues.
My favourite resources
I have the free FODMAP A to Z app on my phone to use as a quick reference on what I should and shouldn’t eat.
I also love the recipes and information found on Karlijn’s Kitchen and Calm Belly Kitchen. These sites really helped me throughout the process when I felt disheartened or alone in what I was experiencing. I also still refer to them now for recipes when I’m struggling to think of delicious meals that won’t cause me problems.
Please feel free to get in contact with me about anything I’ve covered in this post. I can only share my own experiences but I’m happy to do that – the good, the bad and the ugly (yes, I mean poo-related topics too!).
IMPORTANT NOTE: I followed clear and regular guidance from a dietitian throughout the process. My only recommendation is that you do the same if you are considering the FODMAP diet.