Wednesday, November 26, 2014

FODMAP

I hit a nerve yesterday when I mentioned IBS, so I'm going to go into more detail today in hopes that it will help some of you guys.

First off, I've had IBS symptoms for about two decades. There's no specific test for IBS. It's more of an exclusionary diagnosis, after everything else is ruled out. I call it a "constellation" diagnosis, because almost every person has different issues and symptoms, and treatment is just as different.

For me, it's been incredibly confusing over the years. I've tried a ton of different diets, and none of them have made any difference whatsoever. It's never made any sense that I can eat some foods that should theoretically be hard on my stomach, but can't really eat others that would seem to be much more gentle. There's never been anything logical about it.

Also, the confounding thing is that it appears to be totally unrelated to stress. Last year, when we were traveling almost every week for hockey, I was exhausted and very stressed, but my stomach was better than it has been in years. Soon after we stopped for the season, though, my stomach ground to a halt, and it's been messed up pretty badly for about seven month, even though my stress level has gone way down.

A few weeks ago, I ran across something called the FODMAP diet. Here's a description from Wikipedia:
FODMAPs are short chain carbohydrates (oligosaccharides), disaccharides, monosaccharides and related alcohols that are poorly absorbed in the small intestine. These include short chain (oligo-) saccharide polymers of fructose (fructans) and galactose (galactans), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols) such as sorbitol, mannitol, xylitol and maltitol.

The term FODMAP is an acronym, deriving from "Fermentable, Oligo-, Di-, Mono-saccharides And Polyols." These carbohydrates are commonly found in the modern western diet. The restriction of these FODMAPs from the diet has been found to have a beneficial effect for sufferers of irritable bowel syndrome and other functional gastrointestinal disorders (FGID). The low FODMAP diet was developed at Monash University in Melbourne by Peter Gibson and Susan Shepherd. Since the development the diet has been studied for its efficacy for individuals with FGID and is now considered beneficial to be commonly recommended for individuals with FGID.

I have almost no idea what any of that means, but the clinical test results are very impressive. The rate of significant improvement was over 65% in the few studies that have been done. That convinced me to try it out.

I started with this: Stanford Health Care: The Low FODMAP Diet. Be warned, though, that this is an incredibly confusing diet, because there's no easily followed, general rule to know which foods are excluded. Nothing I know about food is of any use here, because (for example) some vegetables are okay, while others aren't. Same for fruits, etc. No lactose. No wheat. No a billion other things. You just have to consult the list.

It's also difficult to follow this diet because it seems so random. I was so desperate, though, that I was willing. What you basically do is follow the diet for 4-6 weeks, and if you've improved, you then slowly add foods in the "no" list back into your diet to see which foods cause problems. You won't react to everything on the excluded list, so you need to find out what specifically causes problems.

In some ways, this is like an elimination diet, but you're able to eat more foods at first, and there's a more specific basis for the process.

Most importantly, I'm actually getting better. This is the first diet I've ever followed where I could actually feel a difference. As additional supporting evidence, we had Thanksgiving dinner on Monday (long story), I ate anything I wanted, and I've been in substantial discomfort for the last two days. So I'm back on track today and I'm going to do everything I can to stick to this for the prescribed period.

If you have IBS and have never been able to find anything that helped, this might be worth trying.

Site Meter