Ok, so I know what you’re thinking. A diet? A diet that helped your IBS and changed your life? Read on to find out why this diet is still one I go back to when my IBS flares up.
IBS is something that I have suffered with since I was in my teens. I remember being 13 and sat in A&E as they thought I’d got appendicitis. IBS is not nice and I’ve had pains so strong that the doctor said that they were like contractions.
What is IBS?
IBS affects your digestive system and I’ve bullet pointed below the symptoms of IBS:
- stomach cramps
- acid reflux
- bowel urgency
How I learnt about the diet.
It was roughly 5 and a half years ago that my IBS became terrible. By terrible I mean anything that I ate would result in me bloating massively – to the point where people asked if I was expecting! I had terrible constipation and would spend so much time in the toilet just trying to go (sorry if that is too much information). The cramps and pain was so bad I knew that something just had to give. This is when the doctor compared my pain to those of contractions as they were so intense. It was literally ruling my life.
I’d thought for a while that I may have coeliac disease so decided to go on a gluten free diet in an aim to try and help my IBS. I cannot tell you the difference it made! So I went to the doctors to see if I could be tested for coeliac disease. They said that I needed to eat gluten again for a couple of weeks then they would do a blood test. As soon as I started eating gluten again I went straight back to being as bad as I was before but my blood test came back clear. I’m sure that my doctor thought that I was making it up so I went back a couple of months later and repeated the test again to which the result was the same.
In sheer desperation after the doctors could offer nothing more I scoured the internet for a search of some relief for IBS. This is when I stumbled upon the low fodmap diet. I’d never heard of it before but decided to give it a go.
What is the low fodmap diet?
Fodmaps stands for fermentable olgio di mono-saccharides and polyols. Fodmaps are basically fermentable carbohydrates that are in all foods and it was found that high fodmap foods trigger problems with digestion for some people. The low fodmap diet restricts high fodmaps.
There are four main groups of fodmaps:
- Oligosaccharides: legumes, rye, wheat, a number of fruit and vegetables including garlic and onions.
- disaccharides: milk, soft cheese and yoghurts (any milk product where lactose is the main carbohydrate).
- Monosaccharides: most fruit that contains a stone, some other fruits too and honey (any fruit or food item where fructose is the main carbohydrate).
- Polyols: some fruit and vegetables and low calorie sweeteners.
What evidence is there?
There are many studies that have been done into the effects of high fodmap foods and digestion (March et al 2015; Drossman and Hasler 2016, Ringel et al 2009, Staudacher et al 2012, Bohn et al 2015) just to name a few.
A low fodmap diet was found to significantly reduce symptom severity for abdominal pain.
Significant decrease in the scale of IBS when on the low fodmap diet.
Through a low fodmap diet the likelihood of improving stomach cramps and bloating is 81% and once on the diet the cramps and bloating are improved by 75%.March et al 2015.
At the end of the trial 50% of participants had a reduced IBS severity score.
A diet low in fodmaps reduces IBS symptoms as well as traditional IBS dietry advice.Bohn et al 2015.
What can I use to help me with the diet?
Within the diet there are three stages. The diet is quite complex and I found it took a lot of research and time to get it right as at first I was not under a dietician. The Monash Univsersity Low Fodmap app helped immensely to know and understand which foods were high fodmaps. It is available for around £6 (on both the App Store and Play Store) and uses a traffic light rating to help you clearly see the low fodmap foods. It is honestly so worth it!
The second thing that I used whilst preparing to go on the diet was a book by Dr Sue Shepherd and Dr Peter Gibson called ‘The Complete Low Fodmap Diet’. It also includes recipe ideas which were a brilliant start to give some advice.
Dr Peter Gibson is a Professor at Monash university so this book goes hand in hand with the app. The book gives lots of detail into throughout on how to get the best from the diet.
The three stages.
Stage 1 is all about restriction:
- In this stage you have to be really strict and avoid ALL high fodmap foods. This is why I found the app so useful as I could see straight away what I could eat and it’s so easy to use being on your phone when you do a food shop just to check.
- This stage can last between 2 week and 6 weeks and you should only move onto the second stage when your symptoms have improved.
- Fodmaps are important for the health of your gut so the first stage is not intended to be done for more than 6 weeks. As mentioned before a dietician can advise you on this more accurately.
Stage 2 is all about reintroduction:
- In this stage you begin to reintroduce high fodmap foods back into your diet but only one by one for three days. Keeping a diary is really helpful here. This stage helps you build up an understanding of your tolerance to high fodmap foods.
- On day 1 you introduce a small fodmap portion with a moderate amount of fodmaps. You then see how your symptoms are and if you have mild or no symptoms then you progress to day 2. If you have severe symptoms you stop.
- On day 2 you then introduce a medium fodmap portion with a high amount of fodmaps. Again repeat as day 1 and continue to day 3 if you have mild or no symptoms and stop if severe.
- On day 3 you introduce a large fodmap portion with a very high amount of fodmaps. At this point your 3 days are over and you stop.
- You then wait for 3 days as a cooling off period and if you have no symptoms then you can introduce another food and the cycle begins again.
- It was at this point that I went back to the doctors again and said I think I need to be put under a dietician. They were not to keen on this as they said I sounded like I’d got a pretty good grip of the diet myself so I pushed and was referred to a dietician (my doctor had never heard of the diet!).
- It’s a good idea here to think about those foods that you are really missing. For me it was chocolate! This was also how I found out that I was lactose and gluten intolerant.
- You need to test ALL of the fodmap food groups before you add them back into your diet.
Stage 3 is all about personalisation.
- In this stage you now know what your tolerances are to all of the fodmap food groups.
- It is a time when you can get used to your tolerances and most importantly start to enjoy food again without feeling unwell!
Advice before you start.
- Speak to your doctor about the diet. Get their advice. They know all of your history and are the best to advise you.
- Ask to be referred to a dietician before you start the diet. They helped confirm my suspicions that I had a lactose and gluten intolerance and helped me find out how much I could tolerate which was really important.
- This diet is not easy. I repeat – it is not easy. It is very hard but so worth it in the end.
- Eating out is very hard and you find that you order something that you think will be ok to find that the restaurant has put a dressing on that contains something you shouldn’t have.
- Create a separate space for your food that is all low fodmap. This made it much easier for me. In cupboards that were general I moved high fodmap foods into other cupboards out of the way.
I hope that this blog post has helped you. Please let me know if you start the diet how you get on as I’d love to know! Even now when I start with a flare up I go back to the low fodmap diet and reintroduce things again. I find it works well to reset my body and they say that your body has a cycle so it is good to introduce things that once flared you up to see if they still cause you the same symptoms.