FODMAPS and Your Gut

In my mid-30s, a food sensitivity hit me with the subtlety of a Mack truck. I noticed that after every latte, I’d almost double over in pain. I soon realized it wasn’t the coffee that was the problem, it was the cow’s milk. After that, I adjusted my diet and life became much better—even without ice cream.

But pinpointing problematic foods isn’t always so easy. What happens when it seems like almost everything you eat causes bloating, pain, or gas?

Introducing FODMAPs

Many foods contain carbohydrates called FODMAPs that can cause problems for people. The FODMAP acronym stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” In some people, these short-chain carbs— small sugars and sugarlike compounds— aren’t absorbed well by the small intestine. When they get to the large intestine, gut bacteria ferment them and use them as fuel. The fermentation causes GI issues of all stripes.

What to do

If you suspect FODMAPs may be contributing to your symptoms, talk with your healthcare provider. Meanwhile, keep a food diary for a week or two and record what you ate and how it made you feel afterward. Note bloating, pain, gas, bowel movements, and changes in stool. Record other information that may offer clues, such as whether you were highly stressed. The goal is to look for patterns and distinguish possible food triggers from other causes of digestive distress.

Pay attention to how these high-FODMAP foods make you feel:

■ onions and garlic

■ fruits such as apples, pears, mango, and watermelon

■ beans and legumes

■ wheat- and rye-based foods

■ some dairy products

■ honey

■ products containing sugar alcohols such as sorbitol, mannitol, and xylitol. These are often found in sugarfree products as well as some protein and snack bars.

A three-step experiment

A low-FODMAP eating approach is not intended to be a permanent elimination diet. The goal is to identify which FODMAPs—and what amounts—you can tolerate, with the goal of eating the least restrictive diet possible without symptoms. Many people find going through this process easier if they work with a registered dietitian or other professional.

The process follows three steps:

1 For about 2–6 weeks, high-FODMAP foods are replaced with lower-FODMAP alternatives. For example, instead of peaches, try kiwi or strawberries.

2 If symptoms improve, individual FODMAP groups are systematically reintroduced to determine which types and quantities you tolerate.

3 Foods you tolerate are returned to your diet in amounts that work for you.

Supplements to consider for FODMAP issues

When you’re dealing with digestive issues, it’s tempting to throw everything you can at it, including probiotics. But it may make sense to hold off at first. Some probiotics contain prebiotics such as inulin, FOS or GOS—fermentable carbohydrates that can increase gas or bloating.

Digestive enzymes offer a more targeted approach once a specific food-related problem has been identified. For example, alpha-galactosidase helps break down carbohydrates in beans and veggies that can cause gas.

Be patient. Finding your personal triggers may take time, but it can lead to a much more comfortable way of eating.