Does The FODMAP Diet Reduce Gas and Bloating

Written by Dr. Steve Chaney on . Posted in Diets, FODMAP Diet, Gas and Bloating

Author: Dr. Stephen Chaney

 

fodmap dietCan the FODMAP diet help reduce gas, bloating, diarrhea, and constipation? Everyone suffers from one or more of these symptoms, but nobody talks about them. For some they represent an annoyance. For others they can be incapacitating.

When the symptoms become frequent and start to affect quality of life, the medical community starts to give them names. When the symptoms occur at least 3 days/month for at least 3 months and there are no known diseases causing the symptoms, it is called irritable bowel syndrome (IBS). If the symptoms are also associated with inflammation, it is called inflammatory bowel disease (IBD). The principle forms of IBD are Crohn’s disease and ulcerative colitis.

A Primer On IBS And IBD

IBS is fairly common. Between 10-15% of the US population has been diagnosed with IBS, but experts estimate that as much as 25% of the population experiences symptoms consistent with IBS.

It is also important to understand that IBS is a collection of symptoms, not a disease. The only difference between IBS and the gas, bloating, and diarrhea (or constipation) that many people experience on a fairly regular basis is the frequency and severity of symptoms – and that is an arbitrary distinction. Someone experiencing those symptoms an average of 2 days/month is not significantly different than someone experiencing those symptoms 3 times/month.

While severe IBS can be incapacitating, it does not appear to cause lasting damage to the intestine or predispose to other diseases. Finally, the causes of IBS are largely unknown. Stress, obesity, and food sensitivities may all play a role.

IBD is much less common (0.4% of the US population), but much more severe. It can cause permanent damage to the intestine and can predispose to several diseases, including cancer. For that reason, you should always consult with your physician if you have severe, chronic gastrointestinal issues.

Standard treatment of IBS and IBD has traditionally consisted of recommendations to:

  • Reduce weight if overweight
  • Increase exercise
  • Reduce stress
  • Limit caffeine and alcohol
  • Limit fatty foods
  • If diarrhea is the primary symptom, limit dairy products, fruits, and sweeteners such as sorbitol and xylitol.
  • If constipation is the primary symptom, increase dietary fiber

These interventions generally provide only partial relief of the symptoms, so medications are frequently prescribed to control the symptoms. Unfortunately, many of those medications have significant side effects.

Fortunately, research over the past decade suggests that there is a natural, holistic approach that can significantly reduce the symptoms associated with IBS and IBD, thus decreasing the reliance on medications to treat those diseases. It is something called the FODMAP diet. The FODMAP diet is rapidly becoming the standard of care for IBS and IBD, and the same diet also appears to significantly improve symptoms in people who merely experience gas, bloating, and diarrhea more frequently than they would like. More importantly, the principles behind the FODMAP diet can help almost everyone who experiences occasional gas, bloating, diarrhea and/or constipation.

What Is The FODMAP Diet?

The FODMAP diet was devised over a decade ago by a group of scientists in Australia. Basically, they identified all of the kinds of foods that were known to cause gas, bloating, diarrhea, and/or constipation in susceptible people and put together a diet that was low in all of them.

FODMAP is an acronym that stands for:

  • F – fermentable carbohydrates
  • O – oligo-saccharides
  • D – di-saccharides
  • M – mono-saccharides
  • P – polyols

Of course, that statement comes under the “Aren’t you glad you asked?” category. It is meaningless to most people. A better way to understand this is to look at foods in the FODMAP category. They include:

  • gas and bloatingLactose, found in milk and milk products (especially for people who lack the enzyme lactase)
  • Fructose in high concentrations, found in foods like apples, pears, honey and agave syrup. (30-40% of individuals have problems absorbing fructose).
  • Fructans, found in foods like wheat, onions and garlic.
  • Galacto-oligosaccharides, found in foods like beans, lentils, and soybeans.
  • Polyols such as sorbitol and mannitol, found in fruits such as cherries, apricots, and apples, and as sweeteners added to many “sugar-free” foods.

These are all foods that are poorly digested or poorly absorbed, so they are fermented by intestinal bacteria. It is the fermentation of these foods by intestinal bacteria that causes the gas, bloating, and diarrhea.

Does The FODMAP Diet Work?

The evidence that the FODMAP diet is effective is pretty impressive. For example:

What Does This Mean For You?

On the surface, this seems to be a good news, bad news story.

good news bad newsThe good news is that the FODMAP diet is incredibly effective at decreasing frequent gas, bloating, abdominal discomfort, diarrhea and constipation – and it really doesn’t matter whether you have been diagnosed with IBS or IBD, or you are just someone who suffers from those symptoms more frequently than you would like.

The bad news is that the FODMAP diet is very restrictive. You can appreciate that when you look at the list of high FODMAPs foods you need to avoid. That means:

  • The diet is very difficult to stick to long term. In the follow up study described above only 30% of the participants were able to stick with the diet for the full 16 months.
  • The diet restricts so many foods that you would really need the guidance of a registered dietitian to design a nutritionally adequate diet plan.

 

The reality, however,is that very few people actually need to restrict all the high FODMAP foods to enjoy significant relief from their symptoms. Clinically, most physicians test various FODMAPs in their IBS and IBD patients and only restrict the ones that cause symptoms. You can do exactly the same thing yourself. Start by reducing groups of high FODMAP foods on the list. Once you have identified which food groups cause your symptoms, you can test foods within that group one by one.

The most important news is that the FODMAP diet concept may help many people who struggle with occasional gas, bloating, and diarrhea. Let me give you one example:

  • Let’s suppose you have discovered that foods made from wheat flour cause you g.i. problems. You have concluded that you are gluten intolerant and carefully avoid foods containing gluten, but you still have occasional gas, bloating and diarrhea. You might be sensitive to the fructans in wheat, not the gluten. If so, a quick glance at the FODMAPs list suggests a number of fructan-containing foods you may be sensitive to that you would never have expected if you just focused on avoiding gluten. For example:
  • Vegetables: garlic, onions, asparagus, artichokes and snow peas might be causing you trouble.
  • Fruits: grapefruit, nectarines, plums and watermelon could be causing you problems.
  • Processed foods: Inulin, a naturally occurring fiber, found in Jerusalem artichokes, is primarily a fructan. Inulin and several other naturally occurring fructans are added to many processed foods to increase their fiber content. These foods might also be causing you trouble.

This is just the tip of the iceberg. Most of us have probably identified one or two problem foods that we know give us gas. By using the FODMAPs list we may be able to identify other foods we should avoid.

 

The Bottom Line

  • By restricting all foods known to cause gas, bloating, diarrhea and constipation in susceptible individuals, scientists and clinicians have created something called the FODMAP diet.
  • The FODMAP diet has proven to be very effective at reducing those symptoms in people with IBS or IBD, but it is also equally effective at eliminating symptoms in individuals who simply suffer from gas, bloating, abdominal pain, diarrhea and/or constipation more frequently than they would like.
  • The low FODMAP diet is also very restrictive, but the good news is that most people don’t need to eliminate all of the foods in the diet. You can systematically test and eliminate the individual foods that cause your symptoms.
  • Most importantly, the FODMAP concept can help us identify problem foods that we might have otherwise never suspected of giving us gas. You will find an example of how this concept works in the article above.
  • Gas, bloating, abdominal pain, diarrhea and constipation can also be caused by a number of serious diseases. For that reason, you should always consult with your physician if you have severe and chronic gastrointestinal issues.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Trackback from your site.

Comments (2)

  • Nancy Pcsolyar, MA, DA, LDN

    |

    Thank you, Dr. Chaney. for addressing the FODMAP test. Little is written about it but yet the information is essential for people suffering from bloating, gas, etc.

    As always, your unbiased critique of various studies is priceless information especially for those of us working in the medical field .

    Reply

  • Anson Kibby

    |

    What an excellent article. Thank you SO much.

    Reply

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

Groin Pain Relief

Posted April 16, 2019 by Dr. Steve Chaney

What Is The Pectineus Muscle And Why Is It Important?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Spring Is In The Air

spring floridaI remember as a child we sang “Though April showers may come your way…they bring the flowers that bloom in May…”

Of course, here in Florida we are blessed with flowers all year, but there’s still a lovely feeling that happens in Spring.  It’s still cool enough most days to go out running, and the humidity is still low.  Traffic will soon be easing up as our friends from the north start their trek back home, and daylight savings time is giving us more time to get to the beach for sunset.  Lovely!

Fun Facts About Spring….

  • The earliest known use of the term “spring cleaning” was in 1857
  • The word “spring” has been used for the season since the 16th century
  • The first day of spring is called the vernal equinox
  • On the first day of spring, the sunrise and sunset are about 12 hours apart everywhere on earth
  • Spring fever isn’t just a saying. Experts say the body changes due to the temperature and can cause an upset in your health.
  • The actual start of spring varies from March 19th to the 21st, but it is commonly celebrated on the 21st.

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

But these activities can also cause a strain on muscles, so don’t forget to take care of yourself. If you put too much strain on muscles you haven’t used all winter, you can develop problems and need groin pain relief.

 

A Tiny Muscle Can Cause Groin Pain

groin pain relief pectineusLately I’ve had several clients come in because of groin pain that has their medical practitioners stumped.  Their symptoms are varied, but most complain that it feels like they hit their pubic bone with a rubber mallet.  Ouch!

One client loves to ride her horse, but the pain had prevented that for several weeks. Another was considering selling the motorcycle that she and her husband love because she just can’t sit on it anymore.

Several years ago, I had a male client tell me that he had this same pain and he was told it could be his prostrate causing the issue.  Fortunately, that wasn’t he problem at all.

The muscle that caused all these problems, and a lot more, is the Pectineus.

The Pectineus muscle originates on your pubic bone and inserts into the very top of your inner thigh bone (femur).

You can see the Pectineus and surrounding muscles more clearly by going to https://en.wikipedia.org/wiki/Pectineus_muscle

Most muscles have more than one function, and this is true for the Pectineus.  The function we’ll look at today is called adduction.  It brings your leg in toward midline.  If you think of a soccer player kicking the ball with the inside of his ankle, it was the Pectineus that helped draw his leg in so he could do the shot.

Each of my clients had pain while trying to bring their leg out so they could sit on their horse, or on their motorcycle.  The tight muscle was pulling on their pubic bone and causing a severe strain.

This muscle is easier to have someone else treat it for you because of its location but give it a try and see if you can locate & treat it yourself.

 

Groin Pain Relief

groin pain relief treatmentThe picture to the left is showing an athlete self-treating her adductors.  These muscles, and the Pectineus muscle, all originate at the same point on the pubic bone.  The picture is showing her massaging the middle of the adductors.

To reach the Pectineus, move the ball all the way up to the crease in your leg.  You can do the treatment with a ball, but because of the size of the muscle and its location, it’s easier to do it with your fingertips.

Sit as this athlete is sitting, and even bring your opposite leg up so your foot is flat on the floor.  For example, in this picture, the athlete would bring her right leg up so her right foot is on the floor, and then lean a bit further onto her left hip.  That opens up the area so she can reach a bit easier into the muscle while using her fingertips.

Press into the muscle, being careful to feel for a pulse, and moving if you feel one.  If the Pectineus is in spasm, you’ll know it immediately when you press on it.  If it’s not in spasm, you won’t be able to find it at all.

Remember to stay within your pain tolerance level, this isn’t a “no pain, no gain” situation.  Never go deeper than what feels tender, but not so much that you want to faint. Hold the pressure for 15 seconds. Then let up on the pressure, but keep your fingers in the same place.

Repeat this movement several times. Each time it will hurt less, and eventually it won’t hurt at all.  That’s when the muscle has completely released, and you will have relief from the pain.

It’s as simple as that!

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

calf cramps remedy bookTreat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/). It is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions.  You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain relief!

 

Wishing you well,

 

Julie Donnelly

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

julie donnellyAbout The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

UA-43257393-1