FODMAP diet may offer relief for chronic digestive problems

So you’ve eliminated the lactose. The fructose. You’ve gone gluten-free. And yet you’re still getting ambushed by those embarrassing bathroom emergencies.

Life should be a gas — not give you it. But many everyday foods containing certain kinds of carbohydrates may be working against you.

“You really have to listen to your body,” said Vivian Serata, clinical nutritionist at Englewood Hospital and Medical Center.

For those with patience, determination and a good nutritionist to help out, there is the FODMAP diet, a six-week process-of-elimination program to help people with irritable bowel syndrome and other chronic digestive illnesses figure what exactly they can and cannot tolerate when eliminating things like lactose isn’t enough.

“Patients with irritable bowel syndrome have visceral hypersensitivity in their guts. They are more sensitive to particular foods than others,” said Dr. Bhavik Bhandari, assistant professor of medicine at Rutgers Robert Wood Johnson Medical School and an attending physician at the school’s Crohn’s and Colitis Center.

Eliminating certain types of carbohydrates known as FODMAPs, Australian researchers have found, can sometimes help alleviate stomach problems. FODMAP stands for — get ready now — fermentable oligosaccharides, dissaccharides, monosaccharides and polyols. In short, they are food building blocks that share small-chain sugars and fibers that some people can’t tolerate.

“Our guidelines for irritable bowel syndrome say first go lactose-free and then reduce gas-forming foods. So beans, raisins, … wheat germ, caffeine, that sort of thing. If you eliminate those, and you’re still having symptoms, this clearly requires the elimination of a lot of other food products,” or the FODMAPs, Bhandari said. “Wheat, barley, rye, fruits, apples, mangoes, watermelon, high-fructose corn syrup, apricots, cherries, cauliflower, chewing gum. Essentially, what you do is go on a diet from six to eight weeks and remove all of these high FODMAP foods and then slowly reintroduce them to see what your body is sensitive to. It’s a very broad elimination diet.”

Other FODMAPs prevalent in the American diet include onion, garlic, pears, mushrooms, asparagus, honey and more, according to researchers.

“When these foods are digested, they create specific types of carbohydrates that cannot be absorbed properly. So it drags more water into the intestine, and since they stay in the intestine, they are rapidly fermented by the bacteria in your gut. That’s what leads to the problems,” Bhandari said.

Low-FODMAP foods include almond, coconut, rice, or soy milks; bananas; bell peppers; blueberries; carrots; cucumbers; grapes; oats; potatoes; quinoa; rice; spinach, kale, and other leafy greens; tangerines; and tomatoes, according to nutritionists.

The diet isn’t new. It’s about 10 years old, actually. But Bhandari said more and more patients seem to have become aware of it recently. Does he think it works?

“There is definitely a subset of patients where this diet is very effective. But it should be done with a nutritionist, because it involves eliminating a wide variety of foods and it needs to be closely monitored,” he said. Bhandari noted it is important for those interested in the FODMAP diet to work with a nutritionist or gastroenterologist who can help you limit FODMAPs in conjunction with a balanced diet that still meets all your nutritional needs.

“My opinion is, it can be good for a lot of people, but it takes a certain person to do it,” said Serata. “You are eliminating a lot of foods, then re-introducing them. Ideally, you want to work with a dietitian and that dietitian needs to instruct the patient to keep a diary of what they are eating, to know what food is helping them or not helping them. I think it can help, absolutely. But the person has to be very dedicated.”

Experts estimate that 20 percent of the American population suffers from chronic digestive illnesses like IBS.

Bhandari and Serata both noted that the FODMAP diet is not a weight-loss plan and should not be used for those purposes.

Email: petrick@northjersey.com

FODMAP diet may offer relief for chronic digestive problems