Welcome to IBSFree.net

Ibsfree.net is your resource for low-FODMAP living: frequently asked questions about FODMAPS (use the search box in the upper right hand corner of the page), product reviews, recipes, and more. 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! Second Edition 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]

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. They do not 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.

[Kristi]

I'm wondering about using nutritional yeast? Is is FructMal/FODMAP friendly? Thank you!

[Patsy Catsos]

I don't know the answer to this one, sorry.

[julie]

Hi again!! I just wanted to reiterate how much I appreciate not only your book, but your dedication to continuing to help people on this site!! I am a young mom of 4 1/2 year old twins, and this book has been a life-saver!! I have IBD & IBS. I have recently started the fructans challenge, but I'm a little confused. I'm trying to follow your instructions to the letter. If I am adding multiple fructans to a meal, multiple times throughout the day, and I start to experience symptoms, how will I know which fructan food item in particular is causing my symptoms?? Does it stand to reason that if one fructan food is a problem, they all will be?? It seems from my past experience, at least, that it would be much more likely for me to have a problem malabsorbing onions, garlic, & asparagus than I would a serving of wheat-pasta. I would greatly appreciate any help & advice you can give me :) Thank you so very much!!

[Patsy Catsos]

I'm glad you are finding the book helpful! Please read this article for a detailed treatment of your question: http://www.ibsfree.net/ibsfree_at_last/2011/08/intolerance-to-a-single-food-dont-overgeneralize.html

Hope that helps, feel free to comment back if you have any follow up questions.

[Nicole Dye]

I went through this elimination diet about a year ago and changed my diet dramatically once I figured out what I could/could not tolerate. I am still sticking with my new diet, but it seems like my body is slowly reverting back to my old symptoms. It is so frustrating! Can this happen? Is it common to get used to the new foods and start having new intolerances?

Also, I've read about a food intolerance blood test called the ALCAT. Have you heard of it? If so, what are your thoughts on it? I know it's expensive, but I almost think it would be worth having it done so I would know for sure what I can and cannot tolerate (to a certain degree, of course nothing is 100% accurate).

[Patsy Catsos]

I would like to address your questions in a very general way, not about you personally, since this blog is educational in nature and can't offer personal medical advice, ok? I wouldn't expect FODMAPs intolerance to shift around like you are describing. Some other kinds of food sensitivities that involve the immune system can do that, though. Sometimes a low FODMAPs diet, by happy coincidence, leads us to drop a food or foods from our diet to which we unknowingly had an immune-mediated sensitivity. then late, we could lose tolerance to a new food. That is where blood testing comes in. ALCAT was one of the first blood tests of this kind, and yes, I have heard of it. Despite how widely available ALCAT is (and how nice their marketing materials are), I don't use it in my practice. I prefer Mediator Release Testing(MRT) by SIGNET Diagnostic Corporation and the LEAP diet program that goes with it for my patients. MRT uses newer technology than ALCAT, is more accurate, and gets better results because of the way the resulting LEAP diet is taught to the patient.

[julie]

Hi Patsy!!
I just today saw that the 2nd edition of your book is now available--I can't wait to buy it!! I'm feeling soooo much better :) I've recently started drinking loose-leaf tea, & I was wondering if teas that contain "challenge foods" would be problematic in tea?? Example: one of the teas I was interested in trying contains pieces of peaches & apples. Thank you so much for any advice / info!!

[Brooke]

hi Patsy,
I got your book to read on my computer, and am very happy with it - everything is so well explained. We've had a huge improvement in our 3 year daughter's symptoms just after several days with restricted FODMAPs, after 7 months of trying everything and several specialist doctor visits who helped with nothing.

Could you please explain two things I am confused about: you say that guar gum as a polysaccharide ferments slowly so it's not really a FODMAP, I also know that Sue Shepherd includes it in her allowed products. However, I think that my daughter gets her symptoms back when eating food containing it, even though these things are from Sue Shepherd's shopping guidebook (e.g. gluten free bread). Some studies talk about how rapidly fermentable guar gum is, e.g. http://www.ncbi.nlm.nih.gov/pubmed/3219318 and just googling 'guar gum' and fermentable tells me how "rapidly" or "readily" fermentable it is, and that it produces so much gas. Can you please explain then why it is allowed? Is it some different kind/part that is used in these products?

Secondly, my daughter gets extreme bloating, gases (and therefore reflux), pain, and once vomitting, after eating anything that has soy flour or soy protein listed as ingredients - even if they are listed almost at the end of the list, and even if she eats small amounts, e.g. two crumbed fish fingers or, on another day, one slice of bread. Some of these products are listed in Sue S.'s guide. From your experience, is it normal to react so severely to really small amounts of soy ingredients? She does not react like that to wheat, only to large amounts, and even then it is not so extreme. Do you think it could suggest soy intolerance, rather than just a normal reaction to one of FODMAPs that people with IBS get?

thank you very much, your help will be much appreciated!

[Patsy Catsos]

The comments below are meant for general discussion of the topics you bring up, and are not medical advice:

Guar gum is a difficult subject. I have seen all the same conflicting and contradictory information as you, but in the end just does not meet the technical definition of FODMAP. Is it close enough to a FODMAP for some people to tolerate it poorly? Yes, so I encourage people to trust their own observations. Why is it allowed? In writing my book, I made the decision to focus exclusively on FODMAPs and not throw in all the other foods and food chemicals that individual people might not tolerate. Gums were one of the toughest calls.

As for the soy, because symptoms related to FODMAPs are dose or load related I would be very surprised if trace amounts of soy ingredients would such significant GI symptoms via FODMAP effects.

[jonathan]

Hi Patsy

Thank you again for your good work. Today's question is -- Horseradish?

As in horseradish flavored mustard, for example. Any thoughts?

Thanks, Jon!

[Patsy]

Hello Jon. I don't have any info on the FODMAP content of horseradish, sorry.

[DiJ]

Hi Patsy,
I have both versions of your book. When I got 2nd edition I decided to go for it and quit my own experimentation (I'd been following the "Alternate" choice in the book). I have been on the Elimination Diet for about a month. I did the Lactose challenge and found I am not lactose intolerant as I had thought I was. I did well on the Fructose challenge. Today I am on the cautious Fructans challenge. I am taking a little longer, not wanting to challenge on the weekends. I have improved in frequency and urgency but still have liquid stools. Should I be happy with this? Do some people improve but not get to "normal" stools on the FODMAPS diet? If at the end of the challenge this is where I am, should I do something further? I did have a very extensive GI workup and had gluten testing which was all negative. Also, I have been very strict about eating only allowed elimination foods. Thanks!!!

[patsy]

When the low FODMAP diet has helped some but not all the way it is time to review and rule out non FODMAP causes of diarrhea. Sounds like you may have reached the limit of what FODMAPs can do to for you.

[DiJ]

Thank you for your quick response, Patty. To clarify what you are saying, would you tell one of your clients to stop the elimination diet at this point or to continue to challenge for the information that may be gained? If "normal" stools (ie non-liquid) are not attained what sort of things would you tell your client to look for/ have tested? Is this when you suggest MRT and LEAP? Is this expensive? Does insurance often cover? Thanks. I am sure you get the same questions over and over. I have tried to read and retain the info from your books and what I find on your site.

[patsy]

I appreciate that you haved done due diligence to search site et cetera. I am working from my phone right no w but when I get back with my computer I will try to write a blog post about your question soon as I can.

[Margy]

The Italian Wedding Soup recipe posted on this web site calls for 1/2 tsp. of onion powder. Is that a mistake? I thought onion powder and/or onions in soups is a FODMAP "no no". Am I wrong?

[Patsy]

Oops, out of date recipe. You are correct, onion poweder contains FODMAPs, and for that matter so does canned chicken broth. Thanks for bringing it to my attention. I've deleted it.

[Chloe]

Hello!! I am on day 4 of the low fodmaps diet and am feeling better already! I am struggling with dinners though.. I love my garlic and onion and soy sauce and stocks.. etc. I am finding spices not enough to season my dishes. Are there any sauces I am allowed to use? I am also vegetarian!

Ideas/help would be much appreciated!

Thank you

Kind Regards

Chloe

[Patsy]

Glad you are feeling better! You can still use soy sauce on the diet but its almost impossible to find commercial sauces, dressings or stocks that don't have onions, garlic, honey or high-fructose corn syrup. Don't forget garlic-flavored oil, vinegars of various kinds, individual herbs and spices such as fresh or dried parsley, basil, dill and more. Try some adapting some recipes for salad dressings, marinades or salsas by leaving out the onions and garlic and replacing with chives, the green parts of onions/scallions, or garlic oil.

[Tracey]

Just asking a question that went unanswered. Can you have horseraddish on the FODMAP diet. Also I read that zucchinni wasn't allowed. Is that true?

[Patsy]

Horseradish is not allowed because it has not been analyzed. Zucchini is allowed according to the latest food composition data I have seen.

[Chloe]

Thank you for your help! I will definitely play around with the ingredients I have then :)

[Di Jasperson]

I was just checking back to see if you had further commented on my questions of July 3. You mentioned you might do a post on it and I was hoping for that. To update you, I did continue with the Elimination phase and felt, even though I didn't attain a "normal" stool, I did improve a great deal and I found out a LOT of valuable information. One was that Fructans are a significant trigger for me. I think that when checking Galactans, if Fructans are a trigger caution should be exercised, as I reacted to them as well. I went back on the Elimination phase for several days and retested with the Galactans that weren't starred and did okay with them. I am finding that my stool is becoming closer to "normal" as I continue to be cautious about filling my bucket with problem foods. I also attribute some improvement to cultured foods and drinks in my diet. Fast transit (and probably antibiotic use in the past)has probably stripped my gut of the ability to make and maintain healthy flora. So by adding those to the diet I am aiding in healing my gut. I do appreciate the improvement I have made. It would not have happened had I not found your book and decided to try the Elimination Diet. One thing that I think you should change, if you do another update, is saying the Elimination phase is only a couple of weeks. One must plan to devote more time than that when you include challenge and eliminate, challenge and eliminate. Perhaps you feel that would discourage some people but I think those of us that are truly looking for help would feel that even a 2 month investment of time is well worth it when you consider the years of suffering we have endured. Thank you again.

[Patsy]

I see what you mean; you do have to keep the elimination diet alive during the challenges, and I appreciate that does take time. Thanks for checking back, I still plan to do that post...summer vacation and post-vaca catch up have slowed me down, but it is still on the top of my list.

[Di Jasperson]

Will look forward to it. Summer is too short. Enjoy!

[Jonette Gibson]

Can anyone purchase the Practice Kit or do you have to be a licensed dietician or nurse?

[Patsy]

Hi Jonette, the kit is designed for dietitians to use in a series of three visits with clients. It doesn't have any top-secret info in it that isn't in the book, the information is just arranged in "handout" form, so it will look better for clients and is sold with "permission to copy for client education only."

[Jonette Gibson]

Which book would this be covered in the 1st or 2nd edition? I am just starting out in following the FODMAP way of eating so wasn't sure which books to purchase. I also see there are quite a few FODmap cookbooks out there, can you recommend a good one that would be good for FODmap/IBS that I can start with?

[Patsy]

Definitely get the second edition, it is more up to date. The first edition should be disappearing from the marketplace as retailers run out of stock on it. I am so busy working on my own cookbook that I haven't had time to read any others, maybe other readers can recommend some.

[Jonette Gibson]

If I am experiencing most of my pain, bloating & gas after lunch. Was it my breakfast that day or what I have the day before that caused it? I have been fighting with Ibs-c for 20+ years now and just starting this new style of eating. Knowing which meal caused the problems will help me a lot.

Thanks for your input
Jonette

[Terry]

I was wondering about a coffee substitute called Dandy Blend and wondered if the extracts would be safe or not. It is made of water-soluble extracts of roasted roots of dandelion, chicory and beets, and the grains of barley and rye. thank you

[Patsy]

It's hard to know for sure which meal is responsible, if any, for the gas and bloating after lunch. Everybody's transit time is different and everybody's tolerance to which FODMAPs is different. That is why we do the protocol in the book, elimination followed by challenges, to learn more about how and when your body reacts to food. Assuming your symptoms improve on the Elimination Phase, you will be reintroducing different kinds of FODMAPs during the Challenge Phase and observing closely the timing and the type of reaction you have. This should help to answer your question.

[Patsy]

Sounds like a cupful of FODMAPs to me; chicory, barley and rye all contain FODMAPs. They are water soluble, so they probably make their way into the beverage.

[Terry]

Thank you for your quick response. I figured it was a cup of FODMAPS - will stick with some black tea!

[Belle]

is coconut flour allowed?

[Patsy Catsos]

Yes, as far as I know.

[Jonette Gibson]

I have recently read that rice (brown/white)has arsenic in it and rice itself should be limited to 2 servings a week and rice products (rice cakes, rice flour, rice cereal, etc) should be limited to 3 servings a week. Have you heard much about this? This would put a damper in what we can eat now since we can't have flour and now rice? this pretty much leaves us to potatoes & squashes.

[Patsy]

Yes, I have been following the reports about rice closely. Sad :( This is a reminder to maintain as much variety as possible in our diets, even on a low FODMAP diet. It is a nutritional mistake to rely too much on any one food. In addition to potatoes and squashes, don't forget we can get carbohydrates from our low FODMAP fruits and vegetables, our lactose-free milk and yogurts, and other grains such as oats, millet, buckwheat and quinoa.

[Terry]

I should check your book - but what about plain wild rice - isn't it different than traditional rice?

[Patsy]

Yes, wild rices are different from traditional rice, though I understand they are from the "tribe" botanically. I don't believe they have been specifically analyzed for FODMAPs yet, but until then I think they are OK, especially since they are so expensive they are usually eaten only in small quantities mixed with regular rice.

[Jonette Gibson]

Does anyone have any suggestions on a cookbook that FODmaps people can follow? That has good recipes that are easy to follow?

[Emily]

Hi Patsy,

I have been following the diet in your book for a little over two weeks now with great success. I am planning my challenge phase and was considering starting with polyols as figs are my favorite food and I miss them :( do you think that any of the foods might be the best test subjects. I worry about something like cauliflower because of its dense fibrous nature. Do you think cauliflower might be more challenging to digest because of reasons other than polyols compared to something like a mushroom?

[Patsy Catsos]

The foods in the challenge lists are in descending order, so the higher the food is on the list, the more effective it will be for a challenge. Yes, there is more to food than FODMAPs, but I would suggest just keeping the focus on them for now.

[Emily]

Thanks Patsy,

I am curious now, I was looking up figs to try to find how much polyols they contain and this site listed them as having none...http://www.healthhype.com/foods-high-in-fructose-sorbitol-fructans-and-fodmaps.html. Is there conflicting evidence around this?

Thanks!!

[Patsy Catsos]

The published data on figs is very old and somewhat conflicting in various databases.Its hard to draw the conclusion that they are safe for the elimination phase of the diet, so I don't recommend them during the dietary experiment. Worth a try later on, though! All dried fruit, if that's how you eat them, can be a potent source of concentrated FODMAPs, though, so use caution.

[ruth]

What is the lag time between eating an offending food and the onset of bloating? I've seen that, for milk products, you know within a couple of hours, but I've also heard that, for some foods, it could be 3 - 4 days before you feel the effects.

Thanks,

Ruth