FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. In a patient with healthy gut function, most of these carbohydrates are beneficial and help to promote the growth of your own beneficial flora. But in patients with digestive disorders, FODMAPs or excessive consumption of fermentable fibers can exacerbate symptoms of gas, bloating, diarrhea, constipation, abdominal pain, and reflux or GERD. This is especially true if you have small intestinal bacterial overgrowth otherwise known as SIBO. The bacteria that overgrows in the small intestines ferments these specific carbohydrates and they produce gas as a result. If you have been prescribed this diet you likely were given another handout that gives you quantities to consume. The list below is a summary sheet of what to avoid. The green, yellow, and red columns on your other handout will guide you further on how much you can have at a serving. Remember each person is different. Our initial goal is to remove the foods so we can see symptom improvement and then test which ones are the biggest problems for you.
Which Foods Have FODMAPs?
High fructose containing foods: Honey, apple, mango, pear, watermelon, high-fructose corn syrup, agave syrup, dried fruit, fruit juice
Fructans: Artichokes (globe), artichokes (Jerusalem), asparagus, beetroot, broccoli, Brussels sprouts, cabbage, eggplant, fennel, okra, chicory, dandelion leaves, garlic (in large amounts), leek, onion (brown, white, Spanish, onion powder), radicchio, lettuce, spring onion (white part), wheat, rye, pistachio, inulin, fructo-oligosaccharides.
Lactose:Milk, ice cream, custard, dairy desserts, condensed and evaporated milk, milk powder, yogurt, soft unripened cheeses (such as ricotta, cottage, cream, and mascarpone cheese).
Galactans:Legumes (such as baked beans, kidney beans, soybeans, lentils, chickpeas).
Polyols: Apple, apricot, avocado, blackberry, cherry, longan, lychee, nectarine, pear, plum, prune, mushroom, sorbitol, mannitol, xylitol, maltitol, and isomalt.
I usually recommend removing all FODMAPs from your diet for a period of 30 days. If this is too difficult I do have a list of quantities of these foods that in some cases can be tolerated.
Each Person's tolerance of FODMAPs is Different
Typically patients have different responses to the different types of FODMAPs. To identify which one is your most difficult, after the initial 30-day avoidance period, you can try introducing one category at a time to see which ones are well tolerated. I find most people end up doing ok with avocado, but have a hard time introducing the white parts of onions. Choose a category, but not wheat or white onions and try slowly adding small amounts into your diet allowing your body time to adjust.
The Dangers of Long-Term Low-FODMAP
I too often see people getting stuck on the low FODMAP diet, but this is not a healthy long term solution. These carbohydrates function as prebiotics in your colon promoting a healthy microbiome.
For more detailed instruction you can establish your self as a patient or you can set up a Wellevate account.
Wellevate is a safe online place to order professional high quality supplements without concerns of corruption or contamination. For more information on these risks you can read the article here (coming.....). Once you create an account Shana can share the IBS /SIBO protocol with you which contains further Low Fodmap instructions. Once you have an account you will have access to professional supplements without risks of receiving counterfeits.
If you want to set up an account or if you want to schedule for an evaluation with the doctor call 360-573-2273 or email firstname.lastname@example.org