Irritable Bowel Syndrome (IBS) is a condition where sufferers experience chronic and/or recurrent gut symptoms in the absence of identifiable structural or pathological abnormalities (1). It is considered to be a functional gastrointestinal disorder, with the main symptoms being constipation and/or diarrhoea. Many sufferers tend towards either constipation or diarrhoea, while others swing between the two.
IBS affects around 11% of the population globally (2), and affects twice as many women as men (1).
How is IBS treated?
There is currently no cure for IBS, and treatment is focussed on relief of symptoms. In recent years, treatment options have advanced dramatically, both in terms of medications and nutrition therapies.
The low FODMAP diet was developed in Australia by Melbourne dietitian Dr Sue Shepherd. It is the most effective dietary strategy for the management of IBS symptoms. It is thought to improve symptoms 70% of patients with diagnosed IBS (3).
What is the low FODMAP diet?
The low FODMAP diet works by reducing a person’s dietary intake of foods that are rich in FODMAPs, which are fermentable carbohydrates found in a variety of healthy, common foods. FODMAP is an acronym which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are simply different types of carbohydrates that can trigger IBS symptoms in susceptible individuals.
Is it a long term diet?
Absolutely not! The diet is used in the short term to establish which foods, if any, are triggers for your IBS symptoms. Triggers vary from person to person, so it’s important to figure which specific foods are a problem for you. The diet is too strict to be followed long term, and doing so could cause negative changes to your gut bacteria. A strict elimination period of around 2-6 weeks is indicated for most IBS sufferers, at which point foods will be reintroduced to determine your individual triggers. People who benefit from a low FODMAP diet will go on to a maintenance diet, where they avoid only the foods they are known to react to.
What can’t you eat on the diet?
The diet reduces your intake of foods that are high in FODMAPs. These include garlic, onion, cauliflower, wheat, apples, pears, fruit juice, mangoes, lactose-containing dairy products and many legumes.
What can you eat?
This diet works by reducing your intake of specific carbohydrates, but protein and fats are not a problem. This means that plain meat, chicken and fish are not a problem, nor are cooking oils, or most herbs and spices (excluding garlic). You can actually enjoy a really varied and delicious diet while minimising FODMAPs! Request an appointment with me and I’ll show you how.
Is it a gluten free diet?
No, it’s not. Gluten is a protein, and FODMAPs are carbohydrates. While the low FODMAP diet does require that you avoid wheat, that’s not because of its gluten content – it’s actually because of its FODMAP content. If you do not have coeliac disease you do not need to avoid trace amounts of wheat, such as that found in condiments, cooking oil, etc. You can actually eat 1 slice of regular bread each day!
Where should I start?
Before embarking on a major dietary change, you need to start with the right information and a clear diagnosis. It’s important that serious medical conditions such as coeliac disease, inflammatory bowel disease and certain cancers are ruled out before diet therapy begins.
Once you have a confirmed diagnosis of IBS it’s time to see an Accredited Practising Dietitian with expertise in this area. If a dietitian is not available to you at this time, the Monash University Low FODMAP Diet app is a great place to start.
- Gibson, P. (2012). Irritable Bowel Syndrome. Australian Doctor. [Article Link]
- Canavan, C., West, J., & Card, T. (2014). The Epidemiology of Irritable Bowel Syndrome. Clinical Epidemiology. [Article Link]
- Gibson, P. (2017). The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome: is it ready for prime time as a first-line therapy? Journal of Gastroenterology & Hepatology. [Article Link]
Page last updated: 20 July 2017