As our awareness of Irritable Bowel Syndrome (IBS) increases, talk about a promising dietary treatment for symptoms – a low FODMAP diet – has become increasingly frequent. So, how can IBS affect your wellbeing? And, what exactly is a low FODMAP diet?
Recent data estimates that 3.5 per cent of Australians and up to 4.1 per cent of the global population are living with IBS (Sperber et. al., 2021), a disorder of the gut-brain axis characterised by recurrent abdominal pain or discomfort associated with bowel habit changes, in the absence of abnormal pathology.
We don’t yet know the cause of IBS, but evidence has shown that things like emotional stress, diet, and changes in routine can contribute to increased onset and severity of symptoms.
IBS is more common in women, and in people under the age of 50, and patients often experience general gut discomfort, bloating, flatulence and diarrhoea. With no cure for IBS, those diagnosed with the syndrome can have their quality of life and general wellbeing severely impacted.
How IBS can impact your day-to-day wellbeing
Jessica Biesiekierski is a Registered Nutritionist, and Senior Lecturer and Researcher at La Trobe University in Melbourne. She is currently researching the mechanisms and efficacy of dietary approaches for the management of gut symptoms.
‘IBS can severely hamper the patient’s quality of life and can result in repeated absence from work as well as suboptimal performance on the workplace. Social activities, leisure, exercise, sleep and travel can also be impaired. There is also an increased healthcare cost,’ she tells Wellbeing by Teacher.
Although there is no cure, professionals can help patients manage their IBS. When IBS is managed, Biesiekierski says the patient’s general quality of life can be improved. An efficacious, evidence-based therapeutic option is the low FODMAP diet, originally developed by Monash University in 2005.
‘The low FODMAP diet is effective in the management of IBS symptoms, and its efficacy is supported by meta-analyses of randomised controlled trials from around the world,’ Biesiekierski says.
What is a low FODMAP diet?
The low FODMAP diet was developed specifically to manage symptoms of IBS. The diet has grown dramatically in popularity – you might have even seen ‘FODMAP friendly’ products on display in the supermarket. The acronym FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. These are naturally occurring carbohydrates found in a wide range of foods.
Researchers discovered that FODMAPs are a group of carbohydrates that are poorly absorbed by our bodies. This results in some FODMAPs increasing small intestinal water and other FODMAPs increasing colonic gas generation, Biesiekierski explains, which, in a patient with IBS – who has hypersensitivity to these effects – can induce symptoms.
The diet involves three stages: FODMAP restriction, FODMAP reintroduction, and FODMAP personalisation. ‘Up to 86 per cent of individuals with IBS will respond (meaning symptomatic improvement to a satisfactory level) in the initial restriction phase of the low FODMAP diet,’ she says.
Managing symptoms of IBS
Because of its complexity, it’s important the low FODMAP diet is implemented under the guidance of an experienced dietitian, Biesiekierski shares.
‘Self-prescribed exclusion diets are not recommended and seeing a GP and/or dietitian before initiating any dietary changes is important to ensure accurate diagnoses of other conditions (for example, coeliac disease),’ Biesiekierski says. ‘The low FODMAP diet is also not recommended long term to avoid any potential consequences on the microbiome.’
Sperber, A.D., Bangdiwala D.I., Drossman, D.A., Ghoshal, U.C., Simren, M., Tack, J., et al. (2021). Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. 2021;160(1):99-114.e3. http://doi.org/10.1053/j.gastro.2020.04.014
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