Welcome to IBSFree.net

Ibsfree.net is your resource for low-FODMAPs living: frequently asked questions about FODMAPS (use the search box in the upper right hand corner of the page), product reviews, recipes, and more. If you own the book IBS--Free at Last! (2009), be sure to seach for the word "update" to make sure you have the latest dos and don'ts. The editor is Patsy Catsos, a registered, licensed dietitian in private practice, and author of IBS--Free at Last! Available from Amazon.com, IBS--Free at Last! includes a step-by-step elimination diet, menus, shopping list, and label reading tips to help you learn to manage your irritable bowel syndrome. Please use the "comments" link at the bottom of each blog post to ask questions so that everyone can benefit from the discussion that follows. Follow Patsy Catsos on Twitter (see sidebar) or "like" IBS--Free at Last! on Facebook to be notified about new posts and other interesting tidbits. Thanks for visiting!

Comments

[Trent Berger]

Hi Pasty....I am curious...is alcohol allowed on your FODMAP diet?

If so...which kinds?
-Beer?
-Vodka?
-Gin?
-Rum?
-Tequilla?
-Triple Sec?
-Bourbon?
-Whiskey?

What about mixed drinks?

[Patsy Catsos]

Yes, in general they are allowed, but watch out for mixers and the sweetened ones like triple sec. Use the search tool in the upper right corner of the blog to find blog posts Ive written about them in the past, there are several.

[Lorelei]

You were so nice to write me back the other day, I thought you might want to know that Barnes and Noble's website is crediting your book to the wrong author! For some reason, it's listed under "Michael Kennedy." Thought you might want to say something to thim about it. Here's a link: http://search.barnesandnoble.com/IBS-Free-at-Last/Michael-Kennedy/e/9780982063507/?itm=1&USRI=ibs+free+at+last.

[Sarah]

Hi Patsy,

This diet approach has been a lifesaver for me! Any tips on adapting it to vegan/vegetarian lifestyle?

Thanks!

[Patsy Catsos]

It should not be too tough for lacto-ovo vegetarians to get by for a couple of weeks during the trial using lactose-free milk products and eggs as protein sources, then after the challenge phase, adding back beans, lentils, and soy products gradually, as tolerated. Vegetarian sources of protein are an important part of the diet, so vegetarians may choose to eat most of their FODMAPS in this form, and keep their buckets from filling up by continuing to use lactose-free milk products, lower FODMAPS fruits and vegetables, and limiting the amount of wheat products in their diets most of the time.

Vegans are going to have a more difficult time. Without lactose-free milk products and eggs it is going to be very tough to get enough protein on the elimination phase. This may be a situation where the alternate approach described in Chapter 6 might be useful. Most vegans are definitely going to be eating galactans in order to meet their protein requirements. Using the food frequency tool in the book, the vegan can review his/her diet for other outstanding sources of FODMAPS and focus on cutting back on them.

[Katie]

Re: the alcohol question you addressed above, I have a further question about dry red wine specifically. I noticed in the book that red wine is in bold in one place (p. 54), and not in bold in another (p. 34), so I'm not sure if it's OK but needs to be carefully limited (like fruits do) or if it's just OK in general. Thanks in advance!! Your book and website are extremely helpful.

[Patsy Catsos]

That was a little typographical issue but it nicely demonstrates my ambivalence about wine. I have some data from the 80s that shows it is FODMAPs friendly, yet I keep coming across undocumented references that it contains mannitol. To hedge my bets, I'd suggest no more than one glass, so yes, portion controlled like fruits. Meanwhile, I continue to search for primary nutrient composition data on wine, so would appreciate sharing if anyone has it!

[Yuxin]

Thank you for answering my email. Your book is very easy to read and follow. I can choose foods from the sample menu or from allowed lists. It is a wonderful book. I am working on elimination phase and I have a question. I have excessive stomach gas which prevents me eating normal amount of food. Burp will help, but sometimes i can not burp. Any suggestions for reliefing the stomach gas and helping burping? Thank you very much.

[Patsy Catsos]

Burping is tricky to solve. I think it is related to FODMAPS in that bloating in the large intestine will press on the stomach and encourage burping or reflux sometimes. One way to make stomach gas less of a problem is to make sure you aren't swallowing excess air through gum chewing or carbonated drinks. It might also be a good idea to check with a doctor to make sure there is not bacteria such as H. pylori in the stomach.

[Elizabeth]

What's the verdict for Barley and FODMAPs?

[Patsy Catsos]

I believe barley is high in FODMAPs, so recommend avoiding it during the elimination phase of the diet, probably challenge with it in the "fructans" groups.

[Anna]

Hi! Thanks for great info in your book and on your website. Hope you´ll be releasing a cookbook in the future! Due to additional diet restrictions, I´m wondering about the classification of a few alternative ingredients: Do you know to which challenge group these foods belong (or maybe some of them could even be "allowed")?
- Millet
- Teff
- Buckwheat
- Yacon (powder or sirup)
- Raw cacao
- Carob
- Psyllium Husk
- Hemp seed
- Palm sugar
- Nutritional yeast
- Bee pollen
- Chlorella
- Spirulina

Thank you : )

[Patsy Catsos]

Thanks, Anna. I am working on a cookbook right now, as it happens.
Millet
- Teff--guessing Fructans
- Buckwheat--allowed on elimination phase of diet
- Yacon (powder or sirup--don't know
- Raw cacao--contains Fructans
- Carob--don't know
- Psyllium Husk--guessing Fructans
- Hemp seed--guessing fructans
- Palm sugar--don't know
- Nutritional yeast--guessing allowed on elimination phase of diet
- Bee pollen--guessing allowed
- Chlorella--guessing allowed
- Spirulina--guessing allowed

Please pass the info along if you ever come across FODMAPS analysis for any of the items I had to guess at. Thanks!

[Anna]

Thanks for your reply - and I´m looking forward to learning some new recipes when your cookbook is out!

Were you not sure about where to put millet - or did it just sort of fall out from the list above? As I´m using millet a lot in baking and cooking, I am now keeping my fingers crossed for it to be in the "allowed"-category...

Will definately let you know if I come across FODMAPS analysis for any of these, or other alternative foods.

Thanks again!

[Patsy Catsos]

Oops, missed the millet. To the best of my knowledge, millet is allowed on the elimination phase. What types of recipes seem to work well with millet?

[Anna]

Oh, great! Some random ideas about how to use millet:

Millet flour:
- Substitute 10% of whatever flour you are using in scones / bread / pancakes etc. with millet flour (in order to get more protein).

Whole millet:
- Use as a side dish, similar to couscous (goes well with hot vegetables, seafood, meat)
- Stir in baby spinach or some fresh herbs of your choice right before serving
- Use cold millet leftovers the next day: serve cold in a chicken salad, (mix with olive oil, lemon juice, salt and pepper, herbs de provence)
- Prepare as a millet porridge for breakfast, add blueberries or allowed fruits and allowed sweeteners / or serve with cinnamon, extra virgin coconut oil and allowed sweetener.

[Anna]

By the way - it´s very easy to prepare and cook whole millet grains:

To prepare:
- Rinse millet grains thoroughly, using a colander, rinse until water is clear.
- Toast millet grains in a skillet for 3-4 minutes, until nutty smell (toasting is optional, but makes the grains less sticky during cooking, and also brings out a nice flavour).
- Then cook the millet grains:

To cook:
- Add 1 cup of millet + 3 cups of water in a saucepan (with a pinch of salt), bring to a boil, reduse heat and let simmer for about 15-20 minutes. Fluff with a fork.

[Patsy Catsos]

Thanks a bunch for all your millet ideas! I need to experiment more with this grain, obviously I have under-estimated it!

[Mike]

Thought this study might be of interest. :)

http://www.ncbi.nlm.nih.gov/pubmed/21615553

[Patsy Catsos]

Thank you for sending this abstract my way. I will definitely get the paper and read it. It's nice to see some research from other institutions corroborating the work being done in Australia.

[Carol]

Patsy, I am excited to start the elimination phase of your FODMAPS diet tomorrow. I am an RN with an ileostomy for 30 years due to Crohns. After almost 30 years with no intestinal problems I was diagnosed (by exclusion) with IBS. Fairly mild according to what many people go through but enough to cause worry about social occasions, travel, etc. Rarely pain but bloating, gas, and diarrhea. Have you had a patient with an ileostomy and is there any differences that I should be aware of?
Carol

[Patsy Catsos]

You've probably seen the recent study that showed ileostomy patients could reduce output with a low FODMAPs diet! I think the approach to the diet will be the same. Do be sure to search the blog for the key word "update" so you have the latest info.

[Leanne]

Patsy, I am currently on a low-FODMAPS diet to pinpoint my food intolerances. So far, I've discovered that fructose and lactose aren't my friends...

I'm going okay on the diet so far - it's just difficult when eating out! I've just been sticking to salads, which is good for the waistline but getting boring!

Do you know of any cafes/restaurants that provide FODMAPS food options? I'm from Sydney, Australia and don't know of any in existence. Been thinking maybe I could open my own cafe one day that is suitable for people like me! But I need to start by doing my research. Any advice you can provide would be greatly appreciated.

Thanks :)

[Patsy Catsos]

I don't know of any cafes or restaurants that formally provide low FODMAPs meal options, so you might be onto an excellent idea for your "someday" cafe. If you want to branch out from salads, you could try ethnic cuisines that rely more on rice, such as Greek, Indian or Thai food; then there's always grilled steak or chicken with baked potato.

[Adam]

Hi Leanne, as a Sydneysider on the FODMAP diet I would love to go to such a cafe/restaurant!!

[Carol]

Patsy,
I am starting my lactose challenge, after doing the fructans and fructose challenges. (I was hoping it was not bread becasue I love bread products!) So far I have not had much in the way of problems, just slight, which is making me think it may turn out to be a combination of the FODMAPS.
I have a question about sorbet and fruit bars. I normally have
something sweet and decaf coffee after dinner. Could not find strawberry sorbet so bought Ciao Bella rasberry. I noticed that immediately and one hour and 2 hours afterwards , I have liquid and bloating. The ingredients are rasberries, organic evaporated cane juice and pectin. Admittedly I just guessed at the amount. Also, I bought 2 kinds of fruit bars from Whole Foods and Kroger organic. I thought they might be the same as strawberry sorbet. One (Fruit Stix) has sugar, strawberry puree and guar gum and xanthan gum. (A polysaccride so not allowed?) The other has carob gum. (Galactose?) Both cause the same issues immediately and one or two hours later. Which ingredient might be the likely culprit? Rasberries, xanthan gum, need to measure more accurately or something else I am missing?

I so appreciate your book and both my husband and I are reading labels now. Can't believe the chemicals and unknown (to us) ingredients in our previous everyday foods! I know that regardless of the FODMAPS we are going to eat more simple foods from now on.

Thanks,
Carol

[Missy C]

Patsy,
I was just told about your web site and book today by a Vermont Nutritionalist. Just ordered your book and can't wait to read it. I have struggled my whole life with many stomach issues, two surgery's, gall bladder removal, IBS, ulcer, colits, polups in the colon, you name it I probably have it. Recently I found that after testing negative for a Gluten and Wheat allergy, if I avoid it I am starting to feel about 80 percent better. I never really understood how much food can effect the way our body functions until recently. I am excited to learn to eat healthier and avoid trigger foods in my diet to have a much happier digestive system. I look forward to your book and reading all of your advice. Thanks!

[Patsy Catsos]

My vote is that the gums and pectin might be causing the problem. They are definitely fermentable. I'm just not sure they meet the full def of FODMAPS (RAPIDLY fermentable and osmotically active), but a lot of my more sensitive clients do not tolerate them.

[Patsy Catsos]

Here's hoping you are soon feeling great!

[Melody Hesseltine]

My doctor gave me a printed list of elimination FODMAP foods that has a 2010 copyright. I then purchased your 2008 book. There are some significant differences in the food lists. Is there other updated information regarding food tolerances? Neither list is more or less restrictive, they just have different foods that are allowed or not. Which should I follow?

HELP!

[Patsy Catsos]

When there are discrepancies between two food lists, the source with the most recent copyright or update takes priority. You can also search my blog in the upper right hand corner for the word "update" and hand-correct your food lists. You might find they will then be a better match for the 2010 list you have in hand.

[jean]

my suspected IBS is constipation dominant. I am embarking on the elimination diet and have to forgo my fiber supplement with inulin.I was told by a FODMAP RD that metamucil was OK.Isn't that psyllium and if so that isn't allowed is it?

Any suggestions for increasing my fiber or for a fiber supplement?

[Ric]

Hi Patsy, first of all thank you for being so dedicated to the site and to answering everyone's queries. The FODMAPs diet has really helped to slow down my daily diahrrea, gas, creaking bowels, SIBO, Candida which has plagued my life for the last 20 years. I just had a query about beer. Most beer is made from Malt barley and hops so I presume barley is allowed on the FODMAP diet? And what about beer made with Maize? If maize isn't allowed then how come cornflakes are allowed?

It seems wrong that something so good like beer should be allowed. Just seems too good to be true.

Also a bit confused about the difference between corn/corn-syrup/High fructose corn syrup etc..

I Look forward to buying your cookbook and updated version of IBS Free At Last when they are published

[Cheryl]

http://apitherapy.blogspot.com/2007/09/study-on-sugar-composition-of-honeybee.html

"The study showed that sugar content of pollen loads dry matter averages 40%. Fructose to be the sugar occurring in the greatest amounts. It accounted for 46% of the total sugar content of the examined samples. The second highest sugar content - 37% - was that of glucose. Monosaccharides expressed as total fructose and glucose accounted for about 83% of the carbohydrate fraction of pollen."

Wondering if bee pollen is still safe on the elimination diet? This study is from 2007, but it id indicate that fructose as in a slightly higher concentration than glucose.

Thank you. Starting the elimination diet TODAY!

[Cheryl]

I saw this study on bee pollen this am.

http://apitherapy.blogspot.com/2007/09/study-on-sugar-composition-of-honeybee.html

it indicates that fructose is present in slightly higher concentrations than glucose in bee pollen.

I have started the elimination diet today and take bee pollen religiously each morning.

Do you comments or suggestions?

Thanks.

[Patsy Catsos]

Hi Cheryl, Thanks for sending the detailed info about bee pollen. On the face of it, I would say no to any food/substance with even .5% more fructose than glucose. However, you should consider the advice of the health care provider who knows you best (and why you are taking the bee pollen) and also the dose of the bee pollen. If it is a miniscule dose, it may not be an important source of fructose.

[linda]

What about Miralax for constipation? Are there any alternatives?

[Patsy Catsos]

The whole FODMAPs elimination diet itself is an alternative to Miralax for constipation. Might not need a laxative at all, or might be able to halve or quarter the dose of laxative needed if the diet works for you.

[Misty B]

If fast food is the only option- what is the best choice I can make? Would a salad with the allowed vegetables and grilled chicken be an okay option on the elimination diet with oil and vinegar instead of the other dressing? I checked websites and they offer nutrition info but not an ingredient list. Are french fries out of the question?

[Patsy Catsos]

Yes, your salad idea sounds like a good one. The french fries would be OK too, but not the ketchup. Wendy's baked potato would be a possibility. Oatmeal at McDonald's and Starbucks.

[Patsy Catsos]

On french fries--some places coat their french fries with flour to make them crispier--forgot to say those would not be allowed. Also note, people with celiac disease or gluten intolerance should make sure the french fry oil is not used to fry anything with flour in the breading or coating.

[Jen]

Hi Patsy, I have struggled with extreme gas in the form of bloating/stomach pain and flatulence for the past 7 years or so. I am what you call a "healthy" eater and love whole grains and fruits/veg with every meal but as I am reading up on FODMAPs I am learning that this so-called healthy eating may not be healthy for me (and my sensitive GI tract). I have self diagnosed myself with IBS as my gas gets worse with larger meals, certain foods (lactose and gas forming fruit/veg), alcohol and stress. I do not experience constipation or diarrhea but do have change in bowel consistency and frequency with certain foods. My question is, do you think the FODMAP elimination diet/trial is right for me? Do you have any other suggestions? Any advice will be greatly appreciated!

[Patsy Catsos]

GI symptoms + high-FODMAPs diet = good candidate. Not much to lose by trying if you've got two weeks to give it. I don't think people necessarily have to have an "official" IBS diagnosis to benefit from the diet, but in general I discourage self-diagnosis, so please discuss your symptoms with your health care provider. On the subject of changes in the consistency of stool, that is somewhat normal and is a result of our varied diet from day to day. If you ate kibble every day like your pet dog or cat, then your BMs would be much more consistent (pardon the graphic imagery)!

[Dr Peter Thatcher]

Jen

Never self diagnose yourself with IBS as sometimes you can be wrong. Always seek the help of a doctor to confirm this. You would kick yourself if you suffer only to find a cure or better control for your symptoms.

Peter

[Rebecca]

Hi Patsy,

Loving the clear instructions in your book! I was just wondering does the 2 week elimination phase need to last 2 weeks? I've been on it for a week since I got your book (and less strictly so, before your book arrived). Can I now start the challenge phase as I am confident that I am symptom free on the elimination phase?

Thanks,

Rebecca

[Patty]

Hi, I have been trying the fodmaps cleanse diet for a couple of months. I have notice some good results but am still having alot of flatulence. I guess I should first tell you that I have had my colon removed (they thought I had ulcerative colitis, I actually had Crohns Colitis)and I now have a j-pouch. My question: is the "no high fructose corn syrup ketchup" ok to use? I have been reluctant about starting the challenge as I am still having some problems.

[Jen]

Thanks Patsy! I started with a food journal the past few weeks to ID any offenders but it seems as though all foods (with the exception of my breakfast) seem to offend me, so it looks like the elimination diet is the way to go, then trial and error. @ Peter, how would you suggest I go about finding an MD who could help me in this area? I haven't had the best experience with doctors in the past but am open to anything that will help!

[Patsy Catsos]

Hope it is going well. When seeking an evaluation for IBS start with your own primary care doctor, who will screen you for "alarm symptoms". Then, if indicated, your doctor can refer you to a gastroenterologist for further evaluation.

[Patsy Catsos]

Regarding ketchup: The two main ingredients of concern in most ketchups are the sweetener and the tomato paste. Even the "no high fructose" kind will still have tomato paste so I do not recommend it during the elimination phase, would include it with the fructose challenge. If you turn out to be fructose intolerant, the "no high fructose" ketchup would be a good lower fructose compromise for many people.

[Patsy Catsos]

Two week elimination phase: I've been on vaca so this answer won't be very timely for you but might help someone else. I do think its a good idea to stay on the elimination phase for the full two weeks. Some others working in this area suggest even longer, at least six weeks, so even two weeks is short compared to that. The main reason is to be more sure that the improvement in symptoms is really due to diet change and not a placebo effect.

[Marie Bard]

I am on a yeast free and sibo free diet. Can I use baking soda or baking powder in my recipes? Thanks.

[Patsy Catsos]

Baking soda should be OK on all of these. Most baking powders contain corn starch, so if your version of the yeast or sibo diets prohibit corn starch baking powder might be a problem. For a FODMAPs elimination diet, both are OK.

[Eileen]

Dear Patsy Catsos,

Regarding chlorella I searched 'polysaccharide chlorella'
and found a research paper which states "using GC-MS to analyze the polysaccharides... the major monosaccharides of CWSP(chlorella) were
rhamnose 31%
glucose 20%
galactose 10%
mannose 5%
xylose 1%"

Are you able to determine from this information if chlorella is a FODMAP safe food?

pubs.acs.org/doi/abs/10.1021/jf902952z

Sincerely and with gratitude,
Eileen

[Patsy Catsos]

Based on the information provided...On the face of it I don't see any FODMAPs there.

[julie]

Thank you so much for this amazing book!! I'm still in the elimination phase & was wondering if salmon is an "allowed" fish?? Also, any info on mustard?? I wasn't able to find much info about it. Thanks so much!!

[Patsy Catsos]

Yes, salmon is fine, and so is any other kind of fish. To the best of my knowledge, mustard is fine. Reminds my of one of my favorite recipes: salmon, spread with whole grain mustard, and a topping of ground walnuts, olive oil, gluten-free bread crumbs, salt and pepper. Baked until salmon is flaky and topping is crunchy. Yummy.