What Is a Low FODMAP Diet & When Should It Be Used?

A low FODMAP diet isn’t right for everyone A low FODMAP diet isn’t recommended for those who do not have irritable bowel syndrome, SIBO, or other functional GI disorders. If you’re struggling to manage digestive symptoms, speak with a qualified holistic doctor or nutritionist to identify which foods trigger symptoms, and how to proceed safely. The low FODMAP diet also may not be the best course of action for those with Celiac disease, because gluten is a protein—not a carbohydrate—so some low FODMAP foods still contain gluten. However, a low FODMAP diet may be beneficial for those with non-Celiac gluten sensitivity if it’s the FODMAPs in wheat that are a trigger, for example. This type of restrictive diet is also not recommended for those with any type of disordered eating, or those who are underweight. Work with a qualified holistic nutritionist to build the right diet for you. FODMAPS & Celiac disease A low FODMAP diet is not necessarily a gluten free diet. However, the low FODMAP diet does remove most sources of gluten such as wheat, rye, and barley. This explains why some people who have a gluten intolerance feel better when omitting high FODMAP foods, when it’s actually the removal of gluten reducing symptoms.  The low FODMAP diet may not be the best course of action for those with Celiac disease, because gluten is a protein—not a carbohydrate—so some low FODMAP foods still contain gluten. However, a low FODMAP diet may be recommended for two main reasons relating to gluten sensitivity and/or Celiac disease (4): You have been diagnosed with or suspect a non-celiac gluten intolerance.You have been diagnosed with celiac disease, but still experience gas, bloating, or other digestive symptoms after avoiding gluten Read: How Do I Know if I Have a Food Intolerance? Symptom overlap with IBS and Celiac disease Most patients with celiac disease are able to resolve their symptoms after following a gluten-free diet, but up to a quarter of those still experience gastrointestinal symptoms even after omitting gluten completely. There is a significant overlap between symptoms of celiac disease and IBS, including bloating, abdominal pain, diarrhea, and constipation. A low FODMAP diet may be a good option to resolve persistent IBS-like symptoms in those with celiac disease who are already gluten-free (5). Low FODMAP diet and IBS Studies show that 50% to 86% of patients have a “clinically meaningful response” to the low FODMAP diet (3). Researchers believe that a low-FODMAP diet is best for those with diarrhea-predominant IBS (IBS-D).  The reason that cutting out high FODMAPs foods is so effective at reducing and even eliminating gut symptoms such as bloating and abdominal pain is due to the removal of the fermentable food source responsible for drawing water and gas into the intestines. For those who are sensitive to FODMAPs, the extra gas and water cause the intestinal wall to stretch and expand. Because people with IBS tend to have a highly sensitive gut, ‘stretching’ the intestinal wall causes exaggerated sensations of pain and discomfort. Shop high-quality digestive support supplements>> Low FODMAP diet in children with IBS Approximately 5% of school-aged children have IBS, according to diagnostic criteria, and evidence has recently emerged for consideration of a diet low in FODMAPs when treating children with IBS. Digestive symptoms in children obviously have a significant negative impact on quality of life, education, and social development. In one study involving 52 children, ages 7 to 17 years old, all the children who completed the study were found to have significantly fewer daily episodes of abdominal pain while following the low FODMAP diet, compared to the Standard American Diet (6). It’s worth noting that the children only followed the diet for 2 days. Maximum symptom improvement occurs in adults at about 7 days, so a longer trial may affect outcome as well (7).  Although popular belief links food intolerances to symptom generation and children report that certain foods exacerbate symptoms, there have been few controlled trials in pediatric cohorts. Related: Probiotics Can Change Your Child’s Behavior Should you avoid FODMAP foods forever? You should not follow a strict low FODMAPs diet for any longer than required. Any investigative diet (like low FODMAP) is designed to identify certain foods that trigger symptoms. There may be serious health side effects to following a very low FODMAP diet in the long-term, such as (8): Decreased vitamin, mineral, and nutrient intakeReduced types of gut bacteria, including BifidobacteriaReduced function of the mucous layer in the digestive system, resulting in inflammationLow SCFA productionDysbiosis A high FODMAP food also contains prebiotic fiber, which is the primary fuel source for even the good bact

What Is a Low FODMAP Diet & When Should It Be Used?

A low FODMAP diet isn’t right for everyone

A low FODMAP diet isn’t recommended for those who do not have irritable bowel syndrome, SIBO, or other functional GI disorders. If you’re struggling to manage digestive symptoms, speak with a qualified holistic doctor or nutritionist to identify which foods trigger symptoms, and how to proceed safely.

The low FODMAP diet also may not be the best course of action for those with Celiac disease, because gluten is a protein—not a carbohydrate—so some low FODMAP foods still contain gluten. However, a low FODMAP diet may be beneficial for those with non-Celiac gluten sensitivity if it’s the FODMAPs in wheat that are a trigger, for example. This type of restrictive diet is also not recommended for those with any type of disordered eating, or those who are underweight.

Work with a qualified holistic nutritionist to build the right diet for you.

FODMAPS & Celiac disease

A low FODMAP diet is not necessarily a gluten free diet. However, the low FODMAP diet does remove most sources of gluten such as wheat, rye, and barley. This explains why some people who have a gluten intolerance feel better when omitting high FODMAP foods, when it’s actually the removal of gluten reducing symptoms. 

The low FODMAP diet may not be the best course of action for those with Celiac disease, because gluten is a protein—not a carbohydrate—so some low FODMAP foods still contain gluten. However, a low FODMAP diet may be recommended for two main reasons relating to gluten sensitivity and/or Celiac disease (4):

  1. You have been diagnosed with or suspect a non-celiac gluten intolerance.
  2. You have been diagnosed with celiac disease, but still experience gas, bloating, or other digestive symptoms after avoiding gluten

Read: How Do I Know if I Have a Food Intolerance?

Symptom overlap with IBS and Celiac disease

Most patients with celiac disease are able to resolve their symptoms after following a gluten-free diet, but up to a quarter of those still experience gastrointestinal symptoms even after omitting gluten completely. There is a significant overlap between symptoms of celiac disease and IBS, including bloating, abdominal pain, diarrhea, and constipation. A low FODMAP diet may be a good option to resolve persistent IBS-like symptoms in those with celiac disease who are already gluten-free (5).

Low FODMAP diet and IBS

Studies show that 50% to 86% of patients have a “clinically meaningful response” to the low FODMAP diet (3). Researchers believe that a low-FODMAP diet is best for those with diarrhea-predominant IBS (IBS-D). 

The reason that cutting out high FODMAPs foods is so effective at reducing and even eliminating gut symptoms such as bloating and abdominal pain is due to the removal of the fermentable food source responsible for drawing water and gas into the intestines.

For those who are sensitive to FODMAPs, the extra gas and water cause the intestinal wall to stretch and expand. Because people with IBS tend to have a highly sensitive gut, ‘stretching’ the intestinal wall causes exaggerated sensations of pain and discomfort.

Shop high-quality digestive support supplements>>

Low FODMAP diet in children with IBS

Approximately 5% of school-aged children have IBS, according to diagnostic criteria, and evidence has recently emerged for consideration of a diet low in FODMAPs when treating children with IBS. Digestive symptoms in children obviously have a significant negative impact on quality of life, education, and social development.

In one study involving 52 children, ages 7 to 17 years old, all the children who completed the study were found to have significantly fewer daily episodes of abdominal pain while following the low FODMAP diet, compared to the Standard American Diet (6). It’s worth noting that the children only followed the diet for 2 days. Maximum symptom improvement occurs in adults at about 7 days, so a longer trial may affect outcome as well (7). 

Although popular belief links food intolerances to symptom generation and children report that certain foods exacerbate symptoms, there have been few controlled trials in pediatric cohorts.

Related: Probiotics Can Change Your Child’s Behavior

Should you avoid FODMAP foods forever?

You should not follow a strict low FODMAPs diet for any longer than required. Any investigative diet (like low FODMAP) is designed to identify certain foods that trigger symptoms. There may be serious health side effects to following a very low FODMAP diet in the long-term, such as (8):

  • Decreased vitamin, mineral, and nutrient intake
  • Reduced types of gut bacteria, including Bifidobacteria
  • Reduced function of the mucous layer in the digestive system, resulting in inflammation
  • Low SCFA production
  • Dysbiosis

A high FODMAP food also contains prebiotic fiber, which is the primary fuel source for even the good bacteria that live in your gut. Here’s why you need prebiotic fiber.

Should you try a low FODMAP diet?

Many people can experience uncomfortable gastrointestinal symptoms when eating excess amounts of FODMAPs, so this kind of elimination diet can be a helpful step toward creating an effective diet plan to manage IBS symptoms. But, like all diet changes, you should be aware of the potential risks, such as changes to your microbiome. When trying an elimination diet, you should always work with a qualified holistic nutritionist or integrative doctor to monitor your health.

If you have IBS, Celiac disease, SIBO, or any other pre-existing gastrointestinal issue, or if you believe you may have an undiagnosed health issue, contact an integrative physician  before starting any elimination diet, including the low FODMAP diet.

Resources 

  1. https://pubmed.ncbi.nlm.nih.gov/24247211/ 
  2. https://pubmed.ncbi.nlm.nih.gov/24830318/ 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390324/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115770/
  5. https://gut.bmj.com/content/67/Suppl_1/A179 
  6. https://pubmed.ncbi.nlm.nih.gov/26104013/ 
  7. https://pubmed.ncbi.nlm.nih.gov/24076059/ 
  8. https://pubmed.ncbi.nlm.nih.gov/22739368/