The Low FODMAP Diet: A Food As Medicine Approach to IBS
Search
Close this search box.

The Low FODMAP Diet: A Food As Medicine Approach to IBS

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

Feeling bloated, unusually gassy and dealing with constipation or diarrhea that feels life-altering?  

Do you have IBS?

Maybe – IBS refers to irritable bowel syndrome-a highly common and frequently diagnosed (and frustrating!) chronic gastrointestinal disorder.  It is characterized by frequent periods of abdominal pain, bloating and either constipation/diarrhea or both (3). Does this sound like you? Unfortunately, this diagnosis is a bit of a catchall and typically given without much recommendation around what to do to improve it. Not to fear-food can be your medicine! Say hello to the low fodmap diet-numerous studies have shown that a short-term low fodmap diet can improve and potentially resolve symptoms of IBS (1,2,3).

Ok, well what the heck are FODMAPS?

FODMAPS are certain types of carbohydrates known to cause gastrointestinal distress like bloating, gas pains and diarrhea or constipation.  More specifically, FODMAP stands for: Fermentable Oligosaccharide, Disaccharide, Monosaccharide, And Polyols. Therefore, a low fodmap diet refers to a restrictive diet in which these types of carbohydrates are removed or greatly reduced.  Funny enough, this diet isn’t necessarily “healthier”. It eliminates many commonly healthy foods like cauliflower and garlic-therefore it is extremely important that it is used short term.  

How do FODMAPs contribute to IBS?

These specific types of short-chain carbohydrates are poorly absorbed by the small intestine and therefore can ferment in the small bowel or the colon (1). They do this in two ways- they can cause an overall increase in osmotic activity or they can cause an increase in gas production (1, 4).  Increased osmotic activity means that certain fodmaps pull water into the small intestine causing abdominal bloating, distention and potentially diarrhea (1). Examples of fodmaps that typically contribute to this symptom includes foods with excess fructose like sugar snaps, pears, honey and sugar alcohols like xylitol.

Secondly, fodmaps that aren’t absorbed well can be rapidly fermented in the colon leading to more gas and associated pain and bloat (3). Think: food baby/belly! Fodmap foods that tend to contribute to these types of gassy symptoms includes high fructan foods like garlic, onion, wheat and cashews. Therefore, a short term elimination should improve these symptoms-specifically, one study showed that up to 86% of patients with IBS found improvement in overall gut-related symptoms such as abdominal pain, constipation, diarrhea, bloating and unusual gas after following the diet (1). 

Ok, so how do I get started on the low FODMAP diet?

It’s recommended to follow a 2-6 week low FODMAP elimination diet in addition to working closely with a dietitian/nutritionist (5).  The goal is to avoid the high fodmap foods and keep the moderate fodmaps as low as possible during the elimination period (it’s called low fodmap not no fodmap for a reason!).  In the chart below you’ll see the high fodmap foods to avoid. After the elimination period, the recommendation is to slowly add back high fodmap foods one at a time, with the guidance of a nutritionist. Typically, it is recommended to challenge in fodmaps at small doses first, working your way up to the larger portion you would typically eat. The outcome is that you should be able to decipher out only a few fodmaps that make you truly symptomatic for the long term.   

What if I feel amazing eating low fodmap and want to eat that way forever?

This diet is meant to be short term! Why? It is not recommended long term due to the risk of nutrient deficiencies and potential altered gut microbiota (1, 5). As you can see below, many extremely healthy foods are left out of the diet and therefore, long term avoidance can set someone up for inadequate intake of fiber as well as vitamins/minerals.  It is important to remember, these are not “bad” foods and the use in the diet is to “quiet down” your symptoms to then decipher out the small handful of foods that are the most triggering for you. Think of your gut like a messy, scribbly black board. The low fodmap diet is the eraser that clears away the mess to allow you to pinpoint the smaller chalkboard marks that are hard to see when the scribbles are there.

Need more digestive support? Schedule a visit with our functional medicine Nutritionist for an in-depth, individualized nutrition consult and meal plan.

 

 

High FODMAP Foods To Avoid:

High Lactose  High Fructose High Fructans GOS High Polyols
Soft cheeses 
Cow’s milk, yogurt & icecream

Asparagus, sugar snaps, sun dried tomatoes
Apples, cherries, fresh fig, mango, brown bananas
Agave, corn syrup, honey, molasses
Onions, shallots, garlic, scallion bulb (white parts), artichoke
Dried fruits, grapefruit, nectarine, peaches
Gluten 
Pistachio & Cashew
Chicory root, carob powder, inulin
Chamomile or oolong tea
Most beans Cauliflower, celery,  mushrooms, snow peas
Avocado
Apricots, pears, plums, watermelon
Sugar alcohols like xylitol

Recommended Supplements For IBS:

IBS- Diarrhea: GI Alive

Inflammation: GI Alive, Fish oil

Gut balancing: Ultrabiotic, Mega Spore Probiotic, GutPro

Bacterial herbal support: Biocidin

General: Probutyrate, Magnesium


Click Here for Low FODMAP Recipes!

 

 

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918736/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622700/
  3. https://www.ncbi.nlm.nih.gov/pubmed/30946302
  4. https://www.ncbi.nlm.nih.gov/pubmed/15948806
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390324/
Our Providers
Quick Links
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

Genova’s SIBO Profiles are non-invasive breath tests which capture exhaled hydrogen (H2) and methane (CH4) gases following patient ingestion of a lactulose solution to evaluate bacterial overgrowth of the small intestine

LOCATION PERFORMED

At home

SPECIMEN TYPE

Breath

COLLECTION INSTRUCTIONS

COST

$85-$225 depending on insurance coverage. 

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the presence of harmful mycotoxins (toxins produced by molds).

LOCATION PERFORMED

At Home

SPECIMEN TYPE

Urine

COLLECTION INSTRUCTIONS

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$699

INSURANCE

Fully covered by Medicare. Repeat test prices $249

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the genetic profile for multiple health indicators. Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Blood Spot

COST

$319

INSURANCE

No insurance accepted

COLLECTION INSTRUCTIONS

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This company can test for lyme, babesia, bartonella and additional tick-borne illnesses. Click here for more information.

LOCATION PERFORMED

In office

SPECIMEN TYPE

Blood

COST

around $1600 (depends on panel selected)

INSURANCE

Fully covered by Medicare. May be reimbursed with PPO plans.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the presence of harmful mycotoxins (toxins produced by molds).

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$299

INSURANCE

No insurance accepted
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates a wide range of environmental toxins that may be leading to harmful health effects.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$199

INSURANCE

No insurance accepted $30 discount given if done with mycotoxins.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

Blood work for blood count, urinalysis and vitamin levels.

LOCATION PERFORMED

BLOOD FLUID

Blood

NOTES

You often have to fast for these tests-please check your providers notes.

COST

Depending on the test, deductible or copay may apply.

INSURANCE

Depends on insurance coverage, deductible or copay may apply.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

Glyphosate (“Round Up”) is a pesticide that is widely used and this test indicates the body’s levels.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

SPECIAL INSTRUCTIONS

Glutathione for 1 week, then bath or sauna.

COST

$99 ($69 if performed with mycotoxins or environmental toxins).

INSURANCE

No insurance accepted $30 discount given if done with mycotoxins or GPL Tox.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates many measures including micronutrients, antioxidants, minerals, detox, overview of gut function, omegas and toxic exposure. Click here for more information.

LOCATION PERFORMED

At home.

SPECIMEN TYPE

Urine

COST

$179 – $400

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

INSTRUCTIONS

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the gut function and indicates microbiome balance, overgrowth, infection, inflammation, parasites and digestive efficacy. Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Stool

COST

$179-$425 depending on insurance coverage.

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

SPECIAL INSTRUCTIONS

No probiotics for one week.

VIDEO INSTRUCTIONS

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the full menstrual cycle, female hormones, and adrenal profile.

LOCATION PERFORMED

At home

BLOOD FLUID

Urine

COST

$160-$329

INSURANCE

Depending on insurance coverage. Fully covered by Medicare.

NOTES

Must be off hormones in order to do the testing.
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test is specifically for a tick-borne illness called “Bartonella”.

LOCATION PERFORMED

In office

BLOOD FLUID

Blood

COST

$260

INSURANCE

No insurance accepted
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test evaluates the presence of potentially harmful heavy metals stored in the body.  Click here for more information.

LOCATION PERFORMED

At home

SPECIMEN TYPE

Urine

COST

Testing: $79 x2 paid to Doctor’s Data
DMSA: $38 paid to Johnson’s Compounding Pharmacy

INSURANCE

Not covered by Insurance
The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test measures saliva cortisol testing throughout the course of one day and informs us where there might be an adrenal imbalance.

LOCATION PERFORMED

At home

BLOOD FLUID

Saliva

COST

$80

INSURANCE

No insurance coverage

The Low FODMAP Diet: A Food As Medicine Approach to IBS
The Low FODMAP Diet: A Food As Medicine Approach to IBS

WHY DO WE DO THIS TEST?

This test is designed to look at food sensitivities (IgG immune responses). It is available in both a 99 or 184 panel. Click here for more information.

LOCATION PERFORMED

In office

SPECIMEN TYPE

Blood

COST

$129-238

INSURANCE

No insurance accepted