It now seems impossible to imagine that a mere 20 years ago you had to rely almost exclusively on the experience and knowledge of your personal physician for help with your medical problems. In today’s information-rich world, anyone with Internet access can personally review the latest research in medical journals, trade notes with other patients around the world, and easily find books that speak directly to the problem at hand. It is quite likely that patients like you may come across effective new therapies for your condition before your doctor does. Enter FODMAPs, the most effective nutrition therapy for IBS to come along in a long time.
Chances are, your doctor has never heard of FODMAPs (extra points for keeping up on professional reading for those who have). Hey, it’s OK to learn something new from a patient—the smartest doctors learn something new every day, and don’t try to pretend they know everything! To help your doctor save a little face, do mention FODMAPs when you make your appointment if you plan to make it a major topic of conversation at your next office visit, so he or she can do a quick bit of research before seeing you.
If your doctor asks you what the heck FODMAPs are, quote the following phrase in doctor-speak: “FODMAPs are rapidly fermentable, osmotically active carbohydrates that can cause symptoms in up to 75% of individuals with IBS. Lactose is an example of a FODMAP carbohydrate, but there are several others as well, including fructose, sugar alcohols, and certain types of dietary fiber.” Then, in a spirit of collaboration, ask your doctor for what you need:
· “Can you refer me to a dietitian for help with a low-FODMAP diet? I’d like to try it, since high fiber diet/fiber supplements/drugs didn’t help me.”
· “It helped, but there is still room for improvement. Are there any other treatments or diagnostics we could consider?”
· It didn’t help, so it would seem that dietary carbohydrate intolerance is not my problem. Can you suggest any other treatment options we haven’t tried yet?”
If you get relief from the IBSFree FODMAP elimination diet, be sure to let your health care provider know. You might inspire him or her to learn more about how FODMAPs can help other patients.
I actually had an appointment with my Gastro (for non-IBS reasons) a week and a half into the Elimination Phase and mentioned it to her. Not only had she heard of FODMAPs (she said they'd recently been written up in the AGM), she applauded me for being willing to go through the process, stating that she had trouble getting her patients to cut 1 thing from their diets, let alone a shift like low-FODMAP entails.
Of course, she was also delighted that I was benefiting from the Elimination Phase (drastic improvement!) and was looking forward to suggesting it to others now with "proof" that it did some good :)
Posted by: Jenn | January 18, 2013 at 12:36 PM
Jenn, that's great! Word is getting around in the GI community now since Gibson and Shepherd spoke last fall in the US!
Posted by: Patsy Catsos | January 19, 2013 at 10:34 PM
My new GI doctor recommended your book. I had followed the SCD diet for 5 years and seemed to be significantly improved. Many frits and veg. approved on SCD are included on fruits/veg to avoid. I am having constipation,gas and bloating problems again and am ready to eliminate Foodmap foods. My question is about almoned flour. I make bread from almone flour. It is a staple for me. Also,I make my own yoghurt allowing it to ferment 24 hours acc. to SCD diet. Your opinion? Thanks
Posted by: Patty Knight | January 22, 2013 at 03:47 PM
The SCD type yogurt fermented 24 hours should be truly lactose free and should be fine on a low FODMAP diet. Almonds and almond flour do have FODMAPs in them, and large or frequent servings of SCD breads could contribute to GI problems for some people. They (Monash Uni) haven't published any nutrient data for nuts yet, but I suggest a limit of about 2 Tb of almond flour per serving. Figure out how many Tb are in your loaf of bread (1 cup = 16 TB) and divide by the number of servings in the loaf to see how many Tb of almond flour are in each serving.
Posted by: Patsy Catsos | January 22, 2013 at 08:42 PM
For almost all my life (40+ years) I have had major sleeping problems and various health problems including constant stomach pain and terrifying headaches.
I kicked a 20+ years sleeping pill habit on my own last winter, but it left me with major insomnia and lots of other problems.
I switched doctor because the previous one was not interested in helping. The new doc landed on an IBS diagnosis pretty fast and recommended that I start reading up on IBS and also that I should consider an elimination diet (she never mentioned FODMAPs though).
I chose your book since it offered just that.
After four months on the diet it turned out that I have gluten intolerance, lactose intolerance and various food allergies (like hazelnuts, eggs).
After converting to a gluten free and lactose free diet and eliminating eggs and nuts, I am a new person. My stomach pain is history, I rarely get headaches, and best of all - I sleep well without sleep medications!
I probably don't even have IBS after all. Yet I find your book to be a treasure trove for those times when I do have stomach issues and try to figure out what I may have eaten and why I react to it.
Please keep up your excellent work! A lot of people will get better lives because of it.
Posted by: Tormod Guldvog | January 27, 2013 at 04:01 PM
Tormod, thank you for sharing your encouraging story. It's a great example of how an elimination diet is supposed to work. Once your symptom level was reduced with a limited diet, it allowed other food intolerances to pop out in high relief. So glad you are feeling better. You now have a number of dietary restrictions, which makes life a little more complicated, but it sounds like you consider it a good trade-off for the health benefits you have gained. Guess I should add to this blog post: There are times when you may have to seek out a another doctor who is willing to partner with you to help you solve your health problem. Some doctors unfortunately tend to discount the important roles of food and nutrition.
Posted by: Patsy Catsos | January 28, 2013 at 01:45 PM
My Gastro just mentioned that I should give the FODMAPs elimination a try. Therefore, I am currently in the research/planning stage and I found a neat experiment with iodine. A droplet of iodine on a food item that turns dark blue/black identifies whether a food has starch or not. Any foods that the iodine stays light brown in color are starch free. However, I'm confused why white potatoes are on the approved list. They are very starchy and completely fail the iodine test. Wouldn't they be considered a fructan/oligo-saccharide?
I'm excited to get started, but I just need to know why potatoes are OK.
Posted by: Christina | February 01, 2013 at 01:10 AM
Don't know about the iodine test, but I do know about potatoes. As you learn more about FODMAPs you will learn that they are either sugars or fibers. Starches are not FODMAPs, thus they are OK.
Posted by: Patsy Catsos | February 01, 2013 at 04:35 PM
I was given the Low FodMap's Diet by my GI MD today. Can you tell me where alcohol stands on this diet?
I HAVE to go on this diet as I can no longer tolerate my abdominal pains. I do however love a glass of wine with my dinner this my question.
Thank you
Posted by: Sharon O'Loughlin | February 06, 2013 at 02:54 PM
Thank you for your book, which I've just read. I'm trying to "take in" the diet details. (There are some foods I KNOW I can't tolerate.) However, I live in Estonia and the ONLY probiotic I am able to get that contains b. Plantarum also contains inulin. (It's called Lacto 7.) Some symptoms have lessened a bit since I started using it about 3 weeks ago - but how much of an issue IS inulin? Should I avoid it? Many thanks!
Peg Oetjen
Posted by: Peg Oetjen | March 05, 2013 at 05:24 AM
No question inulin is a FODMAP, but some people are not as sensitive to it as others, the amount in the probiotic product might be very small, and the benefit of the probiotic might outweigh the negative of the inulin. So each person must decide if a probiotic with inulin or FOS is OK, hopefully with the help of the health care provider who knows you best.
Posted by: Patsy Catsos | March 06, 2013 at 10:42 AM
This is fascinating. As the parent of a young man with autism and severe intestinal dysmotility, i have often rued the lack of research into GI problems and autism - not in relation to inflammation, but rather in relation to dysmotility.
Posted by: Irritable Bowel Syndrome | March 14, 2013 at 03:28 AM
Patsy, is it true that almonds and almond products are not allowed on the low fodmap diet anymore? Please clarify! Thanks
Posted by: Beth | March 17, 2013 at 09:00 PM
On the IBSFree diet almonds and almond butter are OK for the Elimination Phase of the diet in small amounts (2 Tb).
Posted by: Patsy Catsos | March 18, 2013 at 09:03 PM