It has taken me a few further weeks, of ongoing research, including my personal issues with eliminating triggers and adding fibre etc.to my diet, plus information from the internet and various health page to get this article together!
There is still a lot of conflicting advice out there, but the FODMAPs diet information & food list has been gained the Monash University. I have aimed to get a concise informative article together so that it is useful and helpful!
Previous articles shared on my page, where I have talked about Probiotics, Prebiotics, Fibre, the links are joining together! If you have missed them you will find them in the notes section…
Writing this took me back to when I was living in the UK my poor friend (also a brilliant midwife and the one that pushed me to start my Reiki & IHM courses) had to put up with my suffering “moaning” whilst sitting pool side, and we did that 3 times a week then, and to be perfectly honest, I was quite worried about the chest pains, she suggested (being pragmatic and knowing I probably wasn’t having a heart attack) that I kept an eye on what I was eating that triggered the problems and get to the doctor!!
My doctor put me on an elimination diet straight away as the pains were so terrible from the Stomach cramps, heartburn and reflux pretty much all the time, she was great and suggested I cut out everything white – simple carbs and this would be including white vegetables! We never really spoke about the whys and wherefores just how to, which was fabulous for me, I liked that she was willing to try something with me first rather than have to have “the camera treatment” however that was threatened so it’s probably what made me stick 100% to the elimination! I was a bit of a carb addict I guess then, we did a lot of after school activities and often arrived home late in the evening so it was easy to grab a bowl of pre-prepared meals. And it was sooo nay too easy to grab a takeaway! Bonus of living in rural France – no such thing nearby!
Simple carbs also include processed carbs like pastries, white bread, fizzy drink and pasta. It’s obvious why this stuff isn’t good for you as it lacks the fibre and nutrients of fruits and veggies and spikes blood sugar, blood sugar imbalance stresses the liver and the adrenals and promotes inflammation.
The “diet” was hard at first but within weeks I was so much better. However, whilst on the first week of eliminatiion, I went to lunch with my Mum at a local shopping centre and I stood looking at the menu….feeling a bit lost and fed up straight away! NOTHING>>>>>>I could have NOTHING……
Jacket Potato, Pasta dishes, Sandwiches all white, all simple carbs! I asked if it was possible to have the filling of the sandwich with a bit more salad added and the response was “oh no, not another person doing the Atkins diet” RUDE!!! But that seemed to be the general response in the 90’s if you weren’t eating certain foods you must be on a diet! I felt so insulted that her opinion was about diet and not dietary requirements!
Yesterday whilst out with the youngest one, we had pretty much the same thing, the choices of white bread sandwiches galore but my choice was to be a basic salad of lettuce and mozza!
There are many more food intolerances or now more commonly known intolerances anyway now than 20 years ago and I guess it would be just nice to have some other choices for maybe those that don’t wish to eat bread everyday or even have the choice of wholegrain bread!
Anyway, I digress as always, but knowing how food can affect our digestive system makes me a little more intolerant to those people, that then use the fact we are on a “faddy diet” and being fussy! I choose NOT to eat Simple carbs because they make feel ILL, Fruit and Vegetables, well there is still a veritable choice for me, there are some that give me the pains and there are some that don’t, and there is still a way of finding the good ones, elimination! But I will never give up all veggies, I can’t! Remember, NOT all foods are created equal so by avoiding these good ones for life maybe more detrimental to your gut rather than eliminating for a short while and then adding them back in a little at a time! (more about that later)
There are those that do “settle” for foods as a treat, or indeed maybe due to lack of choice or because they can pop a pill to help ease the problems later, for me as I have said before, it’s just not an option! I would actually really rather go hungry than go through the pain of it all! So this leads me to the ongoing research and hopefully armed with more facts and foods that do and don’t acerbate the problem!
What is IBS?
- Irritable Bowel Syndrome (IBS) is a common gastrointestinal condition, estimated to effect between 10% and 20% of the general population. For many people, the cause of IBS is unknown and symptoms vary from person to person.
- The most common symptoms include stomach cramps, bloating, wind, diarrhoea or constipation and other non-gastrointestinal symptoms such as fatigue, nausea, backache, anxiety or depression.
- IBS is more common in women than men, almost twice as common. Although the symptoms can begin at any age, they most commonly begin in people in their 20s. There seems to be an increased prevalence of IBS among relatives of individuals with IBS.
- Anxiety or stress does not cause IBS, but they make the symptoms of IBS worse.
- Practically speaking, it is important to identify any factors that aggravate the symptoms of IBS, whether it be certain activities, certain foods or some medications.
No specific foods have been linked to IBS so there is not “IBS diet.”
Nevertheless, it may be worthwhile to keep a food diary that may help to identify foods that are associated with worsening of symptoms. The foods then may be avoided.
Some foods may aggravate the symptoms of IBS because they alter the function of the intestinal muscles.
For example, caffeine may stimulate muscle contraction.
Fatty foods on the other hand can reduce muscle activity. Either action might aggravate symptoms of IBS depending on what the abnormality is that underlies the IBS.
Some of the symptoms of IBS include:
- Bloating and abdominal swelling
- A change in bowel habits – constipation, diarrhoea or both.
- Abdominal pain and or cramping which is sometimes relieved by emptying the bowel
- Increased wind
- An urgent need to go to the toilet
- The feeling that your bowels have not completely emptied
- Passing mucus from the rectum
- Symptoms can be worse after eating
- Flare-ups can last 2-4 days
Symptoms can also occur in other parts of the body, including:
- Constant tiredness
- muscle and joint aches and pains
- low back pain
- bad breath
- a frequent and/or urgent need to urinate
Some common triggers can be:
- Stress levels
- Toxic lifestyle
- Menstrual pain
- High FODMAP foods
Could diet be causing IBS?
Some dietary triggers are common in many IBS sufferers:
- A diet high in fat
- A diet of rich and/or spicy foods
- Dairy products
- Monosodium glutamate (E621)
Certain food intolerances such as to lactose or fructose may aggravate the symptoms of IBS. Though they are not the cause of IBS their elimination from the diet may improve symptoms.
Monash University in Australia have been researching IBS and have formulated a diet that is known to help relieve symptoms for 70% of people suffering with IBS. This diet is called the low FODMAP Diet.
What are FODMAPs?
FODMAPs are a collection of fermentable short chain carbohydrates and sugar alcohols known to cause unpleasant gastrointestinal symptoms in sufferers of IBS. They can be found in foods naturally or as food additives.
FODMAP is an acronym and stands for:
Fermentable: This refers to the bacterial break down of FODMAP sugars to produce gas.
Oligo-saccharides: There are two main types of oligo-saccharides. The first type is fructo-oligosaccharides (FOS) found in foods like wheat, rye, onions and garlic.
The second type is
galacto-oligosaccharides (GOS)found in legumes and pulses. Both types can cause IBS symptoms.
Disaccharides: This is a double sugar molecule. An example of a disaccharide is lactose, found in milk, yogurt and soft cheeses.
Monosaccharides: This is a single sugar molecule and specifically relates to fructose. Fructose is potentially malabsorbed if it is present in foods in amounts greater than glucose. Foods high in fructose include honey, apples and cherries.
Polyols: These are sugar alcohols found naturally in some fruit and vegetables and are used in artificial sweeteners. These include sorbitol and mannitol.
By reducing intake of foods containing the above, symptoms relating to IBS can be managed.
What is the low FODMAP Diet
The low FODMAP Diet should be followed under the direction of an accredited certified dietician or doctor. Diet is one of the triggers for IBS, but not the only one.
Before following the low FODMAP diet, you should eliminate other known triggers by reducing stress and increasing exercise.
A diet low in FODMAPs may help relieve these problems, particularly in people with IBS. The diet has two phases. The first is the Elimination phase, which lasts up to 3- 8 weeks and eliminates all FODMAPs in your diet.
The second is the Reintroduction phase, which systematically reintroduces FODMAPs. This phase works out the type and amount of FODMAPs you can tolerate before experiencing symptoms. It is important to reintroduce FODMAPs to the extent that they can be tolerated as FODMAPs typically contain prebiotics that aid good digestive health.
Failure to reintroduce food containing FODMAPs may damage your gut and have long term detrimental effects to your health. Reintroducing the FODMAPs you can tolerate widens your food choices. In the long term you should be following a FODMAP controlled diet rather than a low FODMAP diet (i.e. only restricting the FODMAPs you are intolerant to).
Which foods have FODMAPs?
FODMAP carbohydrates include certain natural sugars in foods, and also certain types of fibre in foods. It’s not obvious which foods contain FODMAPs and which don’t.
Here are some interesting examples:-
Some fruits, for example apples, apricots, cherries and pears should be avoided, but others such as bananas, blueberries, cranberries, oranges or strawberries are fine.
Vegetables such as beetroot, garlic, leeks and onions can be culprits, but carrots, courgettes, peppers, parsnips and tomatoes are FODMAP friendlyWheat, rye and barley (in large amounts) are a big NO NO.* Note that FODMAPs don’t have anything to do with gluten or coeliac disease, it’s just a coincidence that FODMAPs are contained in these gluten containing grains.
Milk sugar (lactose) can be problematic, as can all types of legumes, for example baked beans, kidney beans and borlotti beans, also lentils and chickpeas.
Dairy that is lactose-free, and hard cheeses, or ripened/matured cheeses including (If you are not lactose intolerant, you may not need to avoid dairy with lactose.
How to improve your lifestyle and ease IBS symptoms:
In previous article I have spoken about Prebiotics and Probiotics. Probiotics are “good” bacteria that normally live in your intestines and are found in certain foods, such as yoghurt, and in dietary supplements. It’s been suggested that if you have IBS, you may not have enough good bacteria and that adding probiotics to your diet may help ease your symptoms. Recent studies suggest that certain probiotics may relieve symptoms of IBS, such as abdominal pain, bloating, diarrhoea, although additional investigation is still needed, there is no harm in adding a good probiotic to your daily diet.
Symptoms can vary and fluctuate. Sometimes the symptoms are very pronounced, sometimes mild and there are times when they disappear completely.
You have cut out High Fodmaps over time but seeing little or no results.
You may have achieved a suboptimal response to the low FODMAP diet if you did not sufficiently reduce your FODMAP intake. This may occur if you unknowingly consumed high FODMAP foods, or if you had trouble implementing the dietary restrictions. You may need to consider:
Meal size – if you ate very large meals, your FODMAP load may have been quite high
Eating out – if you regularly ate out, you may have consumed larger meals and had fewer low FODMAP options
Processed foods – many processed foods contain high FODMAP ingredients, such as inulin, chicory root, apple/pear juice concentrate, xylitol, isomalt, erythritol and fructooligosaccharides (FOS).
Recipe modification – you may need to adapt your usual recipes to lower their FODMAP content.
Another possibility is that you have another underlying diagnosed or undiagnosed condition that is contributing to ongoing gastrointestinal symptoms. Conditions with IBS-like symptoms include inflammatory bowel disease, coeliac disease and endometriosis. Although these conditions are relatively uncommon (and usually ruled out when your IBS is first diagnosed), if they have not been ruled out, you may need to arrange screening tests with your GP or a gastroenterologist.
If your symptoms are those of diarrhoea then you will be losing a lot of water and potentially causing dehydration. If your symptoms include constipation then this may be due to insufficient water intake. Water helps hydrate the stools, making them easier to pass and reducing the time this toxic waste lingers in your system.
Fizzy soft drinks definitely do not count as water intake!
Water should be drunk throughout the day in small quantities, in order that the body can absorb and utilise it. Flooding your body with a large glass full will ensure that it pours straight through your system!
Get into the habit of drinking water frequently. Don’t wait until you feel thirsty – your body is already dehydrated by then. Have a 1.5ltr bottle to hand – or dispense into smaller bottles to take out with you in the car, to the shops or when walking/exercising! You will need more water when you exercise!
Exercise is so important to our well being, we need to have that feeling that comes after a great work-out whether it be a run, swim, cycle or just a great walk!
So many of us find ourselves sitting at a desk all day, hunched over a computer, which is something many of us do, this can cause havoc with your digestive system.. so it’s really important to move around as much as possible, take a break even if it’s just going to make yourself a drink or have the printer further away from your desk if you are working from home, make a reason to move!
Exercise also plays a big part in de-stressing, as I have mentioned before for me, swimming and zumba are great to get the heart pumping and releasing those endorphins! However you get your buzz from exercise – make time to enjoy it – regularly! It will help….
It’s not totally clear how stress, anxiety, and irritable bowel syndrome are related — or which one comes first — but studies show they can happen together.
If you find that stress is one of your triggers, take time for yourself, many people find that Alternative Therapies help with relaxation, Indian Head Massage and Reiki, Reflexology all will help!
Stress undermines both physical and emotional health. When a person is under prolonged stress, their body increases production of certain hormones which bring about marked changes in blood pressure, heart rate and metabolism. These changes can also cause digestive disorders, for example Irritable Bowel Syndrome or Ulcers.
As always Self-Care is a priority, it is not selfish, it is necessary! Looking after oneself through Diet, Exercise and Relaxation is something your body will thank you for in the long run!
Making a lifestyle change – starts with you!
HOWEVER like anything food related, you have to decide to make the changes, no-one can do it for you…the day where you think – “hang it, I deserve a treat” that could be the trigger day to yet another week of pain and discomfort! Before you decide to go down that slippery slope, think – is it worth the pain I will feel after, Can I avoid eating this? Only you know how that “treat” will make you feel!!
The nutritional side feels like a minefield of what to, and of course what not to eat, in some cases it can be a short period of a few weeks to find the triggers and in others it may take longer! Eliminating foods can be hard, but if you the added help it makes life that bit easier, if you would like the full list of High Fodmap and Low Fodmap foods and feel that guidance, hints and tips will be of benefit to you, then please do contact me!
As with any of the information I share it is from health sites on the internet and from my Nutritional Courses, and generally through my own personal experiences! I am not a practicing health consultant but I do have the ability to help and guide you, whether it is from helping you to learn how to relax using deep breathing exercises or enjoying an Indian Head Massage, the basics of self care the Holistic way….
*It is always best to seek advice from your doctor prior to seeking AlternativeTherapy or nutritional advice. This way we can work together and once the Doctor knows you are seeking alternative help they are quite understanding and in some cases all work together!
*Some symptoms of IBS may indeed be something that is similar to, but not IBS so it is always worth getting checked out and put your mind at rest!