As detailed in my last blog, IBS/Mental Health Update, my IBS has been a lot better than it was this time last year, but, because of COVID-19, I feel that I have taken a little step back in terms of improving the symptoms. This is especially because my tests and further appointments with consultants have been cancelled due to the outbreak.
This has led to a fair amount of soul searching for me, in terms of what I can do to improve my IBS, my mental health and health overall. I have been reading a lot of non-fiction about anatomy and physiology and menstrual cycles, as well as consuming media about IBS to try to improve my understanding of my body, how it works and how I can help it. (Some top recommendations are Melanie Murphy’s channel on youtube, who talks about her experience with IBS and The Gut Loving Podcast, where a dietician and IBS sufferer sit down to tell you about all things IBS.)
In the course of this research, I was reminded of the Low FODMAP diet plan. I have actually tried this diet twice before, both times unsuccessfully, and was waiting for a referral to a dietician to try this diet again to see if it would help improve my symptoms, before the COVID-19 outbreak hit. I realised that, as we are limited in where we can go and in particular, we can only really eat at home, now might be a perfect time to try this (fairly restrictive) diet again. It is definitely recommended that you work with a dietician to follow this diet, especially if you’ve never heard of it before, so I am actually currently trying to find a local, trained, private dietician to help me. However, having tried it twice and having done a lot of research, I feel well-placed to start the elimination phase.
What is the low FODMAP diet?
I am by no means an expert. I am just someone who has had IBS for the last 14 years and has tried (and failed) this diet twice before. This diet is not meant for weight loss and can be quite limited, so is not suitable for following long term. With those caveats out of the way, I will briefly explain the diet and give you some references for further reading/listening.
Why limit FODMAPs?
FODMAPs are fermentable carbs that can trigger symptoms in people experiencing IBS. This is particularly true for people with IBS-D (diarrhoea predominant IBS) or IBS-M/A (mixed symptoms) (more information on the different types of IBS here), as the symptoms that can be triggered by FODMAPS are: cramping, diarrhoea, urgency to go to the loo, gas/wind and bloating. This is because the FODMAPS release gas as they ferment in the gut, which can cause symptoms in people with IBS, as people with IBS have increased sensitive in their digestive system.
What does FODMAP stand for?
Okay, that seems like a pretty complicated name, but it just refers to the types of fermentable carbohydrates found in various foods. Let’s break it down.
Oligosaccharides are found in wheat, rye, legumes and some vegetables, such as onions and garlic (sad face!)
Disaccharides – the main type of carb in this genre is lactose, so they are found in milk, yoghurt and cheese.
Monosaccharides – the main carb is fructose, so they are found in various fruit and natural sweeteners, such as honey.
Polyols are found in some fruit, such as blackberries, and artificial sweeteners.
How does the diet work?
Basically, there are three stages:
For 4-6 weeks, try to eliminate FODMAPS from your diet, as much as possible. This diet is not meant to be completely free of FODMAPs (as you’d end up living off water and air), but as low as possible in FODMAPs. You may notice an improvement in symptoms from the first couple of days, but it could take up to four weeks for you to notice an improvement.
Slowly re-introduce the four groups of FODMAPs, one at a time and a small amount at a time. You may notice that you can tolerate more of some groups than others. This is best done under the direction of a trained FODMAP dietician.
Once you have reintroduced the different FODMAPs and know which ones affect you and how much of each type you can tolerate, personalise your diet. Maybe you’re very sensitive to lactose and should therefore completely avoid it, but are completely unaffected by polyols and can eat as many blackberries as you like. Each personalised diet will look different, but it should mean you can eat a healthy, balanced diet and live a happy and fulfilling life.
My low FODMAP diet
I’m aware that this isn’t going to be an easy swap for me, so, as recommended by The Gut Loving Podcast, I have made a detailed plan for my first week. Some of the recipes are adapted from ones I just know off the top of my head, some are adapted from regular recipes from the web, some are low FODMAP recipes from the internet and some are from The Complete IBS Health & Diet Guide by Dr Maitreyi Raman, Angela Sirounis and Jennifer Shrubsole. I would definitely recommend this book, but be aware that some of the information is outdated (for example, they recommend switching milk for soya milk, which has actually been found to be high in FODMAPs too). If you’re planning your meals out, you can always use the ‘FODMAP’ app by Monash University (who devised the low FODMAP diet) to check a) if a food is low FODMAP and b) what portion size of a ‘red’ food is low FODMAP. So, in the hopes of providing some inspiration for others who are trying the low FODMAP diet.
Extra drinks: water, miso soup, herbal teas, decaffeinated tea
2 The Complete IBS Health & Diet Guide – Dr Maitreyi Raman, Angela Sirounis and Jennifer Shrubsole
3 https://www.bbcgoodfood.com/recipes/turkey-meatloaf (adapted: no beans, onion or garlic)
5 https://www.bbcgoodfood.com/recipes/zesty-lentil-haddock-pilaf (adapted: no onion, 23g dried lentils, 12g flaked almonds)
6 The Complete IBS Health & Diet Guide – Dr Maitreyi Raman, Angela Sirounis and Jennifer Shrubsole
I’ll check in in a few weeks’ time to let you know how I’m getting on and in the meantime, if you have any recipe recommendations for me, please put them in the comments or chat to me on Instagram!