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

Relieve Hip Pain After Sitting or Driving

Posted June 20, 2017 by Dr. Steve Chaney

Relief is Just a Few Movements Away!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

relieve hip pain after sittingI’m on a long business trip, speaking and teaching in Tennessee and New York, and the drive from Sarasota, FL meant many hours of driving over several days.  One of my stops was to visit with Suzanne and Dr. Steve Chaney at their home in North Carolina.  It was that long drive that became the inspiration for this blog.

After all those hours of driving, my hip was really sore. It was painful to stand up. While talking to Suzanne and Dr. Chaney I was using my elbow to work on the sore area, and when we were discussing the blog for this month it only made sense to share this technique with you.  So, Dr. Chaney took pictures and I sat at his computer to write.  I thought others may want to how to relieve hip pain after sitting or driving for long periods.

What Causes Anterior Hip Pain?

As I’ve mentioned in posts in the past, sitting is the #1 cause of low back pain, and it also causes anterior hip pain (pain localized towards the front of the hip) because the muscles (psoas and iliacus) pass through the hip and insert into the tendons that then insert into the top of the thigh bone.  When hip pain reliefyou try to stand up, the tight muscle tendons will pull on your thigh bone.  The other thing that happens is the point where the muscle merges into the tendon will be very tight and tender to touch. You aren’t having pain at your hip or thigh bone, but at the muscular point where the muscle and tendon merge.

It’s a bit confusing to describe, but you’ll find it if you sit down and put your fingers onto the tip of your pelvis, then just slide your fingers down toward your thigh and out about 2”. The point is right along the crease where your leg meets your trunk.

The muscle you are treating is the Rectus Femoris, where it merges from the tendon into the muscle fibers.  Follow this link, thigh muscle, to see the muscle and it will be a bit easier to visualize.

You need to be pressing deeply into the muscle, like you’re trying to press the bone and the muscle just happens to be in the way.  Move your fingers around a bit and you’ll find it.

Easy Treatment for Anterior Hip Pain After Sitting

relieve hip painHere is an easy treatment for hip pain after sitting you can administer yourself.  First, sit as I am, with your leg out and slightly turned.

Find the tender point with your fingers and then put your elbow into it as shown.

It’s important to have your arm opened so the point of your elbow is on top of the spasm.  It’s a bit tricky, but if you move about a bit you’ll come on to it, and it will hurt.  Keep the pressure so it’s tolerable, not excruciating.

After you have worked on this point for a few minutes you can move to the second part of the treatment.

hip pain treatmentPut the heel of your “same-side” hand onto your thigh as close to the spasm as you can get.  Lift up your fingers so the pressure is only on the heel of your hand.  You can use your opposite hand to help give more pressure.

Press down hard and deeply slide down the muscle, going toward your knee.  You can also kneed it like you would kneed bread dough, really forcing the muscle fibers to relax.

I’m putting in a picture from a previous blog to explain how you can also treat this point of your rectus femoris by using a ball on the floor.

As shown in this picture, lie on the floor with the ball on your hip muscle, and then slightly turn your body toward the floor so the ball rolls toward the front of your body. You may need to move the ball down an inch or so to get to your Rectus Femoris.

When you feel the pain, you’re on the muscle.  Just stay there for a minute or so, and if you want you can move so the ball goes along the muscle fibers all the way to your knee.

pain free living book coverIt may be a challenge to find this point, but it’s well-worth the effort!

In my book, Treat Yourself to Pain Free Living, I teach how to treat all the muscles that cause pain from your head to your feet.

Wishing you well,

Julie Donnelly

julie donnelly

About 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.

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.

UA-43257393-1