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The FODMAP elimination diet, and this book, saved my life. Chronic swelling and constipation and pain have followed me for 50 years. Going strict gluten-free for 3 years only made it worse in the end. I had NO IDEA what was causing my gut such distress. My doctor (an internist, not a GI doctor) suggested looking into FODMAPs. OMG. The second day I was on the FODMAP elimination diet, at 4:30 in the afternoon—by which time my gut had ALWAYS swelled up, I looked down at my still-flat abdomen and said out loud, “WHOSE BODY IS THIS???!!!” I am so, so grateful; there are no words...If these fermentable sugars and fibers are your problem, you’re on the road to Glory Land! Good luck!
— Amazon reader review of IBS—Free at Last! February 28, 2013

Many people with IBS find they feel better when they don’t eat wheat, and gluten-free eating is one of the most popular lifestyles today. But wheat is more than just gluten. Wheat contains a complex assortment of proteins, carbohydrates and fats. If you react poorly to wheat it’s important to learn more about the difference between the protein in wheat versus its carbohydrates.

Sometimes people have bad reactions to one of the many proteins in wheat. Examples? Gluten is the wheat protein that causes the symptoms of celiac disease. Celiac disease can cause gas, bloating, abdominal pain, constipation or diarrhea, but symptoms aren’t necessarily limited to the gastrointestinal (GI) tract. The affected person can experience anemia, achy joints, infertility, osteoporosis and more. Gluten can cause an itchy rash called dermatitis herpetiformus, too. Several different wheat proteins can cause classic food allergies or food sensitivities. Non-celiac gluten sensitivity (NCGS) is a newly recognized condition that occurs when a person has a bad reaction to gluten, but does not have celiac. But there, the story starts to get complicated, because gluten grains (wheat, barley and rye) are complicated.

Wheat, barley and rye also contain certain carbohydrates, fructans, which can cause IBS symptoms for some people. Fructans are a type of dietary fiber, one of the FODMAP carbohydrates. Because the US diet revolves around wheat, it’s by far the biggest food source of fructans for Americans. It's not hard to see how much overlap there is between a gluten-free diet and a lower-FODMAP diet.

Consider these tips and discuss them with your own health care provider:

This gluten-free bread would not be suitable for a low-FODMAP diet because it contains fruit juice concentrate.

This gluten-free bread would not be suitable for a low-FODMAP diet because it contains fruit juice concentrate.

  • If you have gastrointestinal symptoms, ask your doctor if you should be tested for celiac disease before starting a low-FODMAP diet. (Once you've cut out wheat, barley and rye from your diet for a while, celiac tests are no longer accurate.)
  • Gluten is not a FODMAP. Sure, some gluten-free foods work well on a low-FODMAP diet as long as other high-FODMAP ingredients aren't added, but gluten-free does not equal FODMAP-free.
  • If you have celiac disease and already eat gluten-free, but still suffer from gastrointestinal complaints, FODMAPs may be to blame. Especially early in your diagnosis, before intestinal healing is complete on your gluten-free diet, you may be prone to poor absorption of lactose, fructose and sorbitol. Once you have been gluten-free for a long time, your ability to tolerate foods containing these carbohydrates may improve a good deal.
  • If you don't have celiac disease, the FODMAP approach might help you discover new ways to liberalize your diet and worry less about consuming minor amounts of gluten, since cross-contamination is not a concern with fructans.

Sometimes it’s easier to sort things out with a look at all the FODMAPS at once, instead of focusing on just fructans.