FODMAPs are certain types of carbohydrates, or more specifically sugars, that are found in foods. FODMAPs include foods with fructose, lactose, galactans, fructans and polyols. Let me break down these funny names for you into common foods that you may find in your diet.
Fructans: High Fructose Corn Syrup (HFCS)-Read the Labels on Foods and Drinks!
Lactose: Foods with dairy like icecream, yogurt, milk
Fructans: Inulin, Wheat, Garlic, Onion
Galactans: Legumes; beans, soybeans, lentils
Polyols: Fruits with "Pits" such as plums, nectarines, cherries, avocado, peaches
Artificial Sweeteners with mannitol, sorbitol, xylitol, isomalt
According to Stanford Health Care FODMAPs are osmotic, meaning they pull water into the intestinal tract. These substances may not be digested or absorbed well and could be fermented upon by bacteria in the intestinal tract when eaten in excess. Symptoms that may occur in people who are sensitive to the effects of FODMAPs are; diarrhea, constipation, gas, bloating and cramping. Removing FODMAPs from the diet is effective in improving symptoms of people with functional gut disorders like IBS.
Monash University Department of Medicine, in Melbourne, Australia has been a major leader in evidence based research and medicine of FODMAPs. Researchers found that restricting one FODMAP in isolation ignores the likelihood that there is potentially a range of FODMAPs in the diet, all of which have similar end-effects in the bowel. The FODMAP concept they purpose is that global restriction should have a greater and more consistent effect than limited restriction. The focus in their study was to reduce all FODMAPs that were consumed in a subjects diet.
Taking a global approach to restriction of carbohydrates that have similar actions (high osmotic effect and rapid fermentation) can help optimize symptom control in patients with IBS. Also, they found that the reason the symptoms are triggered by the ingestion of lactose or fructose in the individual is the response of the enteric nervous system to luminal distension (due to visceral hypersensitivity, excessive gas production due to the nature of the resident microbiota, or motility problems with clearance of the ﬂuid/gas) not because the malabsorption of the sugar is abnormal.
The low FODMAP diet may help manage patients with functional gut symptoms, with an increasing evidence base. However, one must consult with their primary care physician and a dietician prior to implementing. Reduction of wheat products can tremendously decrease ones overall fiber intake which can lead to cancers of the colon and other conditions. Decreasing the overall global intake of FODMAPs will decrease symptoms of IBS and functional gut but is not a cure-all and many do have intermittent symptoms.