Dr. Ahmed If you have been suffering from irritable bowel syndrome (IBS) then you must have explored so many dietary approaches to tame your stomach issue.
Among those methods, a low FODMAP diet has made its mark. However, we are generally unaware of its long-term side effects but luckily, a new study has investigated the safety and nutritional aspects of following a strict low FODMAP diet.
What is the FODMAP Diet?
First, we need to understand what FODMAP means, it stands for fermentable oligosaccharides, monosaccharides, and polyols.
These short-chain carbs are found in several foods that people with IBS can not digest.
When these carbs reach the large intestine in their undigested form they trigger the gut bacteria to ferment them. After this, symptoms like bloating, gas, pain, and other IBS symptoms appear.
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Important points from the new study:
- This study did not measure the severity of IBS symptoms but previous research has shown that a low FODMAP diet can improve these.
- Researchers did not notice any biochemical changes in the blood test after 12 weeks which shows that this diet does not cause nutritional deficiencies.
- Every subject involved in this study consumed the same amount of macro and micronutrients, before and after the low FODMAP period.
- Even though no change was seen in blood tests some participants had low micronutrient levels both before and after the intervention.
- This emphasizes the need for personalized guidance from a professional dietitian while following a low FODMAP regime.
- Also, the overall quality of life was improved but not food avoidance and social reactions. So, this diet can enhance the general well-being.
- Interestingly, the body mass indexes (BMI) of obese and overweight people decreased.
Methodology:
This study involved 36 people (mostly female) who had IBS with diarrhea or mixed bowel movements for 12 weeks.
These participants followed a low FODMAP diet under the supervision of a trained dietitian. Their diet history, bloodwork, weight, IBS symptoms, and quality of life were tracked throughout the study.
They also looked for deficiencies, changes in nutrient intakes, or their impact on symptoms (though symptom improvement wasn’t directly measured).
Their analysis showed that subjects did not have any changes in their nutrient levels except for those who had micronutrient deficiencies before and after the study.
So, a low FODMAP diet must only be followed after getting personalized guidance from a professional dietitian.
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Important considerations:
If you wish to follow this diet to treat IBS then talk to your doctor or a registered dietitian first. They will analyze your condition and take into account any health or medical histories.
As we know that nutrients or foods can interact with drugs so a professional will be able to help you avoid such instances.
They will guide you through the elimination and reintroduction phases and make sure that your body has all the nutrients it needs.
Remember that this diet is only a tool to manage the symptoms and you should not stop taking your IBS medications while following a low FODMAP diet.
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How to manage IBS without a low FODMAP diet:
Even though a low FODMAP diet is a valuable tool it is still not a complete solution. You can follow the strategies given below to manage IBS.
Lifestyle strategies:
Stress is a big problem for IBS symptoms so try relaxing methods like yoga, meditation, or deep breathing to help manage them.
Also, regular physical activity can help you improve both gut health and stomach pain [ref].
While enough sleep is important for everyone, it is significant for people with IBS as well.
There are other techniques like cognitive behavioral therapy (CBT) which can help you handle the emotional side of IBS and make it easier for you to cope with the symptoms mentally.
Dietary considerations:
If anything other than the FODMAP diet is causing your IBS flares then keeping a food diary with you will help track it. In this diary, you can note down what and when you eat and how your symptoms react to the food item.
While some FODMAPs are fermentable fibers, it is still important to get enough fiber for gut health. You should eat low-FODMAP fiber sources like psyllium husk or gluten-free oats.
Do not forget that staying hydrated is crucial for digestion and can help prevent constipation which is a common IBS symptom.
Complementary Therapies:
- As you might know, probiotics are live bacteria that can contribute to a healthy gut microbiome.
- So, you should add probiotic supplements or probiotic-rich foods like yogurt (check FODMAP content) after consulting your doctor.
- Studies suggest peppermint oil may help tone down IBS symptoms like bloating and cramping [ref].
- Remember to consult your doctor before using peppermint oil supplements, as they can interact with medications.
Newer Therapies for IBS:
- Because IBS is a worldwide problem, newer medications are being tested and some of them have already been approved for the treatment of IBS. These include:
- Linaclotide (Linzess) for IBS-C (IBS with predominant symptoms of constipation)
- Viberzi (Eluxadoline) for IBS-D (IBS with predominant symptoms of diarrhea)
- Trulance (Plecanatide) for IBS-C
- Tenapanor (Ibsrela) for IBS-C
- Lubiprostone (Amitiza) for IBS-C
- Zelnorm (Tegaserod) for IBS-C
- Other mainstays of treatment include antidepressants such as paroxetine and tricyclic antidepressants which are effective to treat the symptoms of IBS as well as the anxiety and mood disorders associated with IBS.
There is no one-size-fits-all solution for IBS and what works wonders for one person might not be as effective for another.
What you need to do is experiment with different methods and diets to see what works best for you and keep yourself under the supervision of trained personnel to avoid any nutrient deficiencies.
Methods like keeping a food diary to track individual triggers beyond FODMAPs could be helpful as well.
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