The low FODMAP diet has been a real game changer when it comes to the management of IBS (irritable bowel syndrome). For some people, it gives them a level of control over their symptoms that they have never experienced previously. They love the results so much that they never want to stop the diet! But this could be a problem long term.
The low FODMAP diet is not meant to followed strictly for more than 6-8 weeks. We know that the diet is effective in controlling IBS symptoms for the majority of IBS sufferers, but we don’t know what impact this diet will have on a person’s gut microbiome long term. Given that this diet cuts out prebiotic foods that are known food sources for “good” bacteria, it’s likely that the impact will not be positive.
But the flip side of this is that IBS symptoms can cause long term problems as well. People with IBS are more likely to suffer from depression and anxiety, and are at increased risk of developing colo-rectal cancer. Some people suffer IBS complications that leave them requiring bowel resections and the use of a stoma for the rest of their life. Clearly, IBS needs to be managed, but the real question is how to do this long term without negatively affecting your microbiome.
The solution to this problem is FODMAP challenges. The low FODMAP diet should only be followed until symptoms resolve, or for a maximum of 8 weeks. At this point, it’s of critical importance to reintroduce foods that were previously eliminated, in order to determine which foods were causing the problem. It is highly unlikely that all of the foods eliminated in the low FODMAP diet are a problem for each individual. In fact, for most FODMAP responders, there will be a range of FODMAPs they struggle with, and some they don’t. For example, one person might have no issues with fructose, but be acutely sensitive to fructans. Conversely, another person might be exquisitely sensitive to polyols and GOS with very little fructan sensitivity. It really comes down to the individual and their symptoms.
Once you know which FODMAPS are a problem for you, you can reintroduce the foods that don’t give you any problems at all. The only foods you should be avoiding long term are the foods that you know to be a problem for you – this is your maintenance diet, a modified low FODMAP diet. This approach will increase the variety in your diet, which is key to the health of your microbiome.
For specific advice on how to manage your IBS symptoms and whether the low FODMAP diet is right for you, click here to request an appointment with me (either in person at the Brisbane clinic or via Skype) or click here to read more about the services I offer.