How a low-FODMAP diet can help ease IBS symptoms

Excruciating gut pain, constipation or diarrhea can signal IBS. So what is irritable bowel syndrome and how can you keep it under control?

If you are among the one in five Australian adults who suffers from irritable bowel syndrome (IBS) you will be familiar with the bloating and unbearable abdominal pain that comes after eating.

You know the feeling of scanning for a toilet wherever you go in case of a sudden bout of diarrhea.

What is IBS?

IBS is a condition of the digestive system, known as a functional gastrointestinal disorder and more recently described as a brain-gut relationship disorder.

It affects the intestines and while not dangerous, can be uncomfortable – with symptoms including abdominal pain, bloating, diarrhea and constipation.

There is no known cure for the condition, which affects more women than men, and its causes can be difficult to establish but may include diet, stress, infection and medications.

Dietitian Jane Freeman notes potential triggers are not limited to what you eat.

“Diet is just one aspect. Your gut is neurological, so stress, anxiety and psychological challenges also have gut function,” Jane, a spokeswoman for Dietitians Association of Australia, says.

“So you may need to work with a psychologist as well as a dietitian to manage your IBS.”

The good news is diet has proven to be a powerful tool in managing chronic intestinal disorders.

How can IBS be treated?

IBS requires long-term management and can include prescribed and over-the-counter medication, as well as drug-free treatments.

There is evidence that gut-directed hypnotherapy can improve gastrointestinal symptoms of IBS for at least five years, while Monash University research found hypnotherapy can reduce symptoms of IBS in patients by 70 per cent.

Thankfully for most, a dietary change – namely a low-FODMAP diet – is enough to improve symptoms.

A low-FODMAP diet and IBS

FODMAPs are a collection of short-chain carbohydrates, or sugars, which the gut does not absorb properly and can contribute to symptoms of IBS.

High-FODMAP foods include:

  • Yoghurt and milk
  • Garlic and onions
  • Apples
  • Mushrooms
  • Wheat or rye breads

Low-FODMAP foods include:

  • Eggs
  • Feta cheese
  • Blueberries
  • Potatoes

Monash University gastroenterologist Professor Peter Gibson and nutrition scientist and dietitian Associate Professor Jane Muir led a team that developed the low-FODMAP diet in 2005 and as a result, the Monash FODMAP App.

“If taught by a dietitian, three out of four people will have good amelioration of symptoms,” Prof Gibson says.

“The first phase is to replace high-FODMAP foods with low-FODMAP foods to determine if the diet has benefit.

“The second is to rechallenge with specific foods to identify the specific FODMAPs and the dose that seem to induce symptoms.”

Prof Gibson says the third phase – a personalised approach – is about learning to create a maintenance diet.

“Most people do not need a lot of restriction overall,” he says.

“The strictness of the diet can be altered according to how the IBS is as the severity does fluctuate.”

How long does the low-FODMAP diet take to work?

Dietitians Australia says switching to a low-FODMAP diet for two to six weeks appears to considerably benefit most IBS sufferers.

However, Jane says it is important to be diagnosed by a doctor or dietitian first.

“It’s really important to understand that the low-FODMAP diet is a test diet,” Jane says.

“There are obviously lots of different gut problems and a common one that’s missed is coeliac disease. It’s important to rule those out.”

Learn more about IBS and the FODMAP diet on The House of Wellness TV show, on Channel 7 at 2pm on Friday and noon on Sunday.

Written by Dan Imhoff.