September 25, 2013

FODMAPs is an acronym used to describe short chain carbohydrates that are poorly absorbed in the small intestine by some people with sensitive guts, namely those with Irritable Bowel Syndrome (IBS).

When certain food components (carbs and sugars like FODMAPs) are not absorbed in the small intestine, they make their way into the large intestine where the gut bacteria act upon them and have a feast. This interaction results in fermentation of the sugars within the carbs which triggers the release of gas.  The types of symptoms that occur are bloating, distention and a change in the speed of intestinal contractions (gut motility), leading to constipation (slow contractions) or diarrhea (fast contractions) or sometimes a combination of both.

FODMAPs include:

  • Fermentable
  • Oligosaccharides – are short chains of carbohydrate molecules linked together including Fructans, a chain of fructose molecules and Galacto-oligosaccharides (GOS) a chain of galactose molecules. Some Examples:
    • Fructans: Artichokes (Globe), Artichokes(Jerusalem), Garlic and garlic powder, Leek, Onion (brown, white, Spanish, onion powder), Spring Onion (white part), Shallots, Wheat (in large amounts), Rye (in large amounts), Barley (in large amounts), Inulin, Fructo-oligosaccharides.
    • Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils, Chickpeas.
  • Disaccharides – are two carbohydrate molecules linked together including Lactose (composed of glucose and galactose), the sugar found in milk and dairy products.  Some Examples:
    • Milk, ice cream, custard, dairy desserts, condensed and evaporated milk, milk powder, yogurt, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
  • Monosaccharides – are single carbohydrate molecules including Fructose, the sugar found in many fruits and some vegetables.  It does not require any digestion before it is absorbed. When foods containing equal amounts of fructose and glucose are consumed, glucose helps fructose to be completely absorbed.  However, when fructose is present in greater quantities than glucose, fructose absorption depends upon the activity of sugar transporters located in the intestinal wall. The ability to absorb excess fructose varies from person to person. In people with fructose malabsorption,the capacity of sugar transporters is limited and excess fructose travels to the colon where fermentation occurs.  Some Examples:
    • Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup (HFCS), asparagus, artichokes and sugar snap peas.
  • And
  • Polyols – are a type of carbohydrate that humans can only partially digest and absorb in the small intestine.  Some Examples:
    • Apples, Apricots, Avocado, Cherries, Nectarines, Pears, Plums, Prunes, Mushrooms, as well as Sorbitol, Mannitol, Xylitol, Maltitol (all end in ‘ol) and Isomalt, used in sugar-free products like candy, flavored jam and jelly spreads, baked goods and baking mixes, chewing gum and cough drops as well as diet products.  Sugar alcohols mimic the sweetness of sucrose (table sugar), however, because their absorption is much slower, only a small amount of what is eaten is actually absorbed.

The Low-FODMAP diet and the restriction of certain carbs helps reduce the fermentation process and IBS symptoms in about 75% of patients.

garlic

I have had many problems throughout the years, first starting with digestion and the last few years I have had bloating so bad, I look pregnant and the pain from the distention is hard to live with.  I have to wear certain types of clothes just so I can be comfortable (dresses, leggings).  I have had to say no to social gatherings because I am so uncomfortable and have low energy.  Sometimes just working out is no fun because I feel like a huge balloon – from head to toe I feel utterly gross!

Since learning about the low-FODMAP diet, it has totally made sense why I have such horrible pain some days and not others.  The pain and bloating I experience can last for weeks on end or almost cause embarrassing situations.

dairy freeThere are foods that I love and I eat a lot of them (like garlic) but they are on the high-FODMAP list.  Just cutting them out so far has made a difference.

If you have Irritable Bowel Syndrome (IBS) or Celiac Disease I hope you will check out this blog every so often and share your own story too!

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Sources: Dr. Sue Shepherd, and the Canadian Digestive Health Foundation