FODMAP, no I didn’t forget another “O” and misspell this title. The acronym FODMAP stands for Fermentable Oligo-Di-Monosaccharides and Polyols. No wonder we use acronyms, what a mouthful. This is a topic one should consider exploring if they have any intestinal disturbances such as chronic abdominal pain, bloating, diarrhea, cramping, and stool irregularity. The first recommendation, if someone is suffering from the above symptoms, is to seek advice from their medical provider. It has been estimated that half of all adults who suffer from these symptoms have what is called a Functional Bowel Disorder. That is, a routine diagnostic evaluation fails to reveal any underlying condition responsible for these symptoms and would lead to a diagnosis of a Functional Bowel Disorder, or the other diagnosis people may be more familiar with is Irritable Bowel Syndrome.
In light of the increasing popularity of the gluten-free diet, it is vital that healthcare providers also educate patients on the possibility of a low FODMAP dietary approach, to help reduce symptoms related to Functional Bowel Disorder. I am not suggesting that a diagnosis of Gluten-Sensitivity or Celiac Disease is not valid, but for those who choose not to get tested, or have been tested for these conditions and the results are not a positive diagnosis, it may be worthwhile taking a look at a low FODMAP dietary approach. This would help to identify foods other than, or in addition to, gluten that may be leading to intestinal discomfort.
FODMAPs are specific carbohydrates found in foods that may not be digested or absorbed efficiently. When this occurs the remaining carbohydrate in the intestine may pull water into the intestinal tract and/or, become food for bacteria, leading to fermentation and result in the offending symptoms of gas, cramping, bloating, constipation and diarrhea. One of the most common FODMAPs is lactose, the natural sugar found in milk. For some, limiting lactose in their diet is effective at limiting the symptoms related to Functional Bowel Disorder, for others it involves the possibility of all the FODMAP carbohydrates causing the offensive symptoms due to their additive or collective effect.
This is a brief overview of the FODMAPs that could be present in your diet:
- Fructose (fruit; some higher in content than others, agave, honey, high fructose corn syrup)
- Lactose (sugar in mammalian milk and milk products)
- Fructans (wheat, onion, garlic, cabbage, chicory, inulin)
- Galactans (soy products, legumes, broccoli)
- Polyols (apple, cherry, avocado and sweeteners containing sorbitol, mannitol, xylitol, maltitol)
For a more extensive list of foods rich in Fructose, Lactose, Fructans, Galactans and Polyols refer to the following web links:
- Stanford Hospital and Clinics
- Today’s Dietitian
- Journal of Gastroenterology and Hepatology
The best way to discover if you are sensitive to a particular food is to keep a detailed food diary that identifies foods you are eating and symptoms that consistently occur after the consumption of a particular food. This is very useful data for your medical provider and yourself when looking for possible causes of intestinal discomfort. Remember we are all unique, none of us have the same thresholds or tolerance to substances, we each know our bodies best and, we are our own best health advocates.
I remember my mother making this statement to me as a child, “I like onions but they don’t like me”! FODMAPs comes to mind.
1. Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010; 25(2): 252-258.
2. Hauser W, Layer P, Henningsen P, Kruis W: Functional bowel disorders in adults. Dtsch Arztebl Int 2012; 109(5): 83-94. DOI: 10.3238/arztebl.2012.0083.
3. Scarlata K. The FODMAPs Approach- Minimize Consumption of Fermentable Carbs to Manage Functional Gut Disorder Symptoms. Today’s Dietitian 2010. Vol.12,No.8, P.30
4. Staudacher, H.M., Whelan K., Irving, P.M., and Lomer M.C.E. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nut Diet 2011, 24, pp. 487-495.