How a Low FODMAP Diet Can Help with IBS Symptoms
FODMAP is a scientific term that is commonly used to describe a group of carbohydrates that may be more difficult to tolerate in individuals with IBS or a compromised GI tract. Specifically fermentable oligo-, di-, mono-saccharides and polyols.
These carbohydrates can be found in a wide range of foods and beverages and while some foods contain just one type, other foods may contain several types of FODMAPs. Amounts can vary from one item to the next and can also be dependent on portion size.
So, you may be asking – How can FODMAPs affect tolerance during digestion?
FODMAPs may not be completely digested or may not absorb fully in the gut, which can trigger gastrointestinal (GI) symptoms in kids who have Irritable Bowel Syndrome (IBS) or other GI disorders.
Common GI symptoms for kids with IBS may include abdominal pain and discomfort, bloating, passing gas, distension, diarrhea, and constipation.
In the small intestine, FODMAPs move slowly and absorb water so that by the time they pass into the large intestine, they are fermented quickly by bacteria in the gut.
This extra gas and water cause the intestinal wall to stretch and expand, which produces uncomfortable GI symptoms in some children. Since children with IBS have highly sensitive guts, this can lead to pain and discomfort, bloating, diarrhea and/or constipation, among other issues.
Starting a Low FODMAP Diet
A low FODMAP diet may be extremely beneficial for some children with medically-diagnosed IBS. The purpose of a low FODMAP diet is not to permanently eliminate all FODMAPs but rather to identify and minimize the types of carbohydrates that contribute to digestive symptoms.
When starting your child on a low FODMAP diet, it is generally recommended to completely eliminate all high-FODMAP foods for a few weeks with the guidance of your doctor or dietitian (see list below). If FODMAPs are the cause of GI distress, then your child may experience relief within a few days. However, if you do not see symptoms resolution within the first few weeks it is important to note that it may take longer, and some physicians may recommend complete elimination for as long as 6 weeks.
During the initial weeks of FODMAP elimination, it is important to completely eliminate all high FODMAP foods. Over the next several weeks, individual FODMAPs are reintroduced back into the diet one group at a time while closely tracking the return of symptoms. The goal in the reintroduction phase is to identify the groups and amount of FODMAPs that are contributing to the symptoms and then use this information to make longer-term dietary changes to avoid these foods.
It is important to introduce only one food at a time over a 3-day period to help more clearly identify possible trigger foods. As you are introducing a food, you will also want to increase the serving size every day to help identify the amount that is tolerated. This can be helpful in determining which foods are causing the troublesome symptoms.
Since starting a low FODMAP diet can be difficult, it is recommended that you talk to a physician or dietitian first, as they may be able to help you avoid unnecessary dietary restrictions.
Studies have shown that people with common digestive disorders who are on low FODMAP diets can experience reduced pain and bloating. These benefits are generally apparent within 2-6 weeks after starting a low FODMAP diet.
While the diet does not cure IBS, it may help children live more comfortably with their condition. This may be related to the evidence that a low FODMAP diet can have a positive impact on IBS symptoms, especially abdominal pain and bloating, reduced distension, and/or diarrhea or constipation.
It is important to remember that a low FODMAP diet does not improve symptoms for ALL children with IBS. In these cases, other diet therapies may be needed in addition to, or as a replacement of a low FODMAP diet.
Managing a Low FODMAP Diet
As seem with any restricted diet, children may be exposed to trigger foods when you are not present and may also struggle with having limited options. This is why is can be so beneficial to work with a dietitian to ensure variety and balance is continued.
Keeping a list accessible at all times of low and high FODMAP foods may help you and your child.
In addition, Monash University offers a FODMAP app that is frequently updated to help identify low FODMAP products from major food brands and a library of low FODMAP recipes. They even have shopping lists that you can print and take with you to the grocery store. You can learn more and download the app here: https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/.
Access a library of low FODMAP recipes of meals and snacks
You can refer to the lists below as a starting point for identifying foods that you may want to give your child, and foods to avoid while on the initial phase of the low FODMAP diet. Keep in mind that some of the foods listed under the ‘Low FODMAP’ list is determined by portion size and are not unlimited in amounts. If you have three low FODMAP fruits in one sitting, this may add up to a moderate or even high FODMAP meal depending on the quantities consumed.
Low FODMAP Foods:
- Meats, fish and eggs, unless they have added high-FODMAP ingredients like wheat or high-fructose corn syrup
- All fats and oils
- Most herbs and spices
- Nuts and seeds: Almonds, peanuts, macadamia nuts, pine nuts, sesame seeds (avoid pistachios and cashews)
- Fruits: Unripe bananas, blueberries, cantaloupe, grapefruit, grapes, kiwi, lemons, lime, mandarins, melons (except watermelon), oranges, passionfruit, raspberries, strawberries (ask your doctor or dietitian for recommended servings)
- Sweeteners: Maple syrup, molasses, and stevia
- Dairy products: Lactose-free dairy products, hard cheeses and aged softer varieties like brie and camembert
- Vegetables: Bell peppers, bok choy, carrots, celery, cucumbers, eggplant, ginger, green beans, kale, lettuce, chives, olives, parsnips, potatoes, radishes, spinach, green onions, squash, sweet potatoes, tomatoes, turnips, yams, water chestnuts, zucchini (ask your doctor or dietitian for recommended servings)
- Grains: Oats, rice, quinoa, sorghum, tapioca (ask your doctor or dietitian for recommended servings)
- Beverages: Water and tea
This list is neither definitive nor exhaustive, and keep in mind that every child is different and may not tolerate some foods either because of FODMAPs or for other reasons.
High FODMAP Foods:
In order to minimize exposure, you may want to avoid these common foods and ingredients during the initial phase of the diet:
- Fruits such as apples, apricots, blackberries, canned fruit, pears, peaches, watermelon
- Sweeteners such as fructose, high fructose corn syrup, honey, xylitol, sorbitol
- Dairy products such as milk, ice cream, most yogurts, sour cream, soft and fresh cheeses and whey protein supplements
- Vegetables such as asparagus, broccoli, Brussels sprouts, cabbage, cauliflower, garlic, mushrooms, okra, onions and peas
- Legumes such as beans, chickpeas and lentils
- Wheat such as bread, pasta, some breakfast cereals, tortillas, waffles and crackers
- Other grains such as barley and rye
- Beverages such as soft drinks with high-fructose corn syrup, milk, soy milk and fruit juices
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