FODMAP SYMPTOMS
FODMAP SYMPTOMS: the low down
FODMAP symptoms are centered around the gut: bloating, diarrhoea and/or constipation (both can occur), gut pain and excess wind.
​
Symptoms typically occur 3-12 hours after consuming a high FODMAP food. Reactions cannot happen instantaneously as the foods needs to travel to the intestines before symptoms can be provoked.
FODMAP subgroups such as fructose, lactose and the polyols (sorbitol and mannitol) are the smallest FODMAPs so tend to move through the gut faster and thus symptoms can be triggered faster: around 3-4 hours after consuming the food.
FODMAP subgroups such as fructans (wheat fructans, onion fructans, garlic fructans and fructans found in some fruits and vegetables) and GOS (for example found in legumes, peas) are larger and travel more slowly in the gut so symptoms can be more delayed for example much later in the day or the next day.
​
​Specialists and Dietitians talk about IBS (Irritable Bowel Syndrome) as being diarrhoea or constipation dominant or being a mixture of both.
There are some other associated issues with the gut issues such as reflux, fatigue, feeling awful and there can be bladder irritability as the nerves close to the gut are also close to the bladder.
Most people don't have all the symptoms but their own personal constellation of the above symptoms.
​
* The LOW FODMAP diet has been shown to work best for the bloating and diarrhoea symptoms.
I have also noticed that any related reflux also seems to respond well to the LOW FODMAP diet.
See Your GP First
It is highly recommended to do a medical work up and check that there are no medical reasons for your Irritable Bowel Syndrome (IBS) symptoms as gut symptoms can occur due to a variety of causes.
​
Coeliac Disease is more common in people with IBS (3.3%) than those in the general population (0.3-1%) so could be easily missed. Doing a screen for Coeliac does require consuming the equivalent of 2 slices of bread (can be sour dough bread for LOW FODMAP) every day 4-6 weeks leading into the blood screen otherwise the test is not valid if negative.
Endometriosis for some may be causing significant gut issues (this is very common) so removing the FODMAPs and getting an improvement may mean that the endometriosis diagnosis may be missed.
​
It is also useful to check if gut parasites are causing the gut issues. This generally forms part of a normal screen for a medical check of gut issues.
Other possible underlying issues causing gut symptoms may include:
​
-
Bile Acid Diarrhoea: 50% of people with Irritable Bowel Syndrome (diarrhoea dominant) are thought to have diarrhoea due to inadequate amounts of bile acid in their gut to cover the amount of fat in the diet. This sort of diarrhoea is very watery, and loose with urgency, faecal incontinence, but does not usually involve pain. This is a distinguishing feature as Irritable Bowel Syndrome usually involves pain.
​​
-
Pancreatic Insufficiency: less common, causes fatty bowel motions that are pale, very smelly and hard to flush down the toilet (due to the fat content). Often the sufferer is male, and may have the issue due to excess alcohol causing issues with pancreatic enzyme production.
​​
-
Microscopic Colitis: symptoms can come and go but when present, the diarrhoea is very watery, often with faecal incontinence/leakage, urgency and often sudden onset. Non digestive symptoms can also occur including brain fog, and nausea. A scope + biopsies (biopsies required, not just a scope on its own) is recommended to help diagnosis microscopic colitis.
​​
-
SIBO (Small Intestinal Bacterial Overgrowth): overgrowth of bacteria into the small intestine (where it should not be). Many irritable bowel symptoms (IBS) and has been described as IBS on steroids with persistent bloating and distension, with onset 30-60 minutes after eating, and in addition, serum iron and B12 levels can often be low while serum folate can often be high.
FODMAP ELIMINATION FOR FAST RESULTS
REDUCING FODMAPS if you are FODMAP SENSITIVE should produce results within days or a week, so is quick to take effect.
​
When FODMAPs are out of the gut, gut symptoms tend to quickly settle, so if this is not occurring, check to see if you are mistakingly still having FODMAP rich foods in the daily diet.
​
The beauty of the LOW FODMAP diet is that you can quickly get results.
Guidance is highly recommended, as doing it on your own means the diet always be will be longer and more difficult, and may not be properly implemented. You can then quickly move on to trials and expanding the diet.​
​
Read more about the first step in the LOW FODMAP diet: LOW FODMAP elimination and choose between the new Simplified LOW FODMAP Elimination or the Full FODMAP Elimination.
One can start with the Simplified FODMAP elimination and progress to the Full FODMAP elimination if required. Both eliminations work very quickly so doing the step up approach does not lengthen the diet much more than 1-2 weeks.
MINING
YOUR
DATA
Most people who are FODMAP sensitive have some suspicions or insights as to which foods trigger them which can give some insight to a Specialist Dietitian (ahem, myself) with regards to what sub groups of the LOW FODMAP diet look like triggers, if the diet can consequently be made easier by keeping in someFODMAP groups such as dairy lactose or wheat fructans and also if it looks like there may be some other sensitivities in play. Finding out about other sensitivities is possible via a thorough assessment that looks at your food symptoms, seeing if they go beyond the gut, as well as any LOW FODMAP foods that look like to be a personal trigger for you. This personal information helps with diagnosing the most likely food intolerance in place as well as helping to craft a personalized LOW FODMAP diet if LOW FODMAP does seem to be the best elimination diet to pursue.