The FODMAPs diet is used to help manage irritable bowel syndrome (IBS), and it’s becoming more popular.
FODMAPs are a group of carbohydrates found naturally in a wide range of foods, including garlic, onion, dairy, many fruits and vegetables, breads, cereals, pulses, nuts and many manufactured foods.
FODMAP is an acronym that stands for Fermentable Oligo- Di- Monosacharides And Polyols. Our team at Monash University coined the term in 2005 when we showed this group of carbohydrates trigger symptoms of IBS in susceptible people, and reducing all of them together would have a greater impact on IBS symptom relief than reducing any one of them alone.
How do FODMAPs lead to IBS?
FODMAPs attract water as they pass slowly through the small intestine. They then pass undigested into the large intestine where bacteria ferment them. In people with IBS, this leads to excessive gas production and changes in bowel habit, along with many other typical IBS symptoms including pain, bloating and distension.
How should the FODMAP diet be used?
A FODMAP diet is a three step diet best followed under the guidance of an experienced dietitian.
People follow the diet strictly at the start, and relax and personalise the dietary restrictions over time. The aim is to strike a balance between adequate symptom control and a minimally restrictive diet.
In step 1, people reduce intake of all FODMAP groups below a threshold level. The aim of this step is to reduce IBS symptoms. If IBS symptoms improve sufficiently, people progress to step 2.
In step 2, people undertake a series of “food challenges” to determine which FODMAPs they can tolerate.
In step 3, well tolerated FODMAPs are brought back into the diet, while poorly tolerated FODMAPs are restricted, but only to a level necessary to control IBS symptoms.
The success of the FODMAP diet is due to its widespread uptake among patients with IBS. Backed by scientific evidence, the diet is recommended in various local and international clinical guidelines as a first-line IBS treatment.