Our dietitians, Sarah and Laura, are highly experienced in delivering the low FODMAP diet and guiding people through challenges. Sarah helps to facilitate various online support groups for people with IBS from all over the world, including a support group for parents with children on the low FODMAP diet.
There is currently no way to diagnose food intolerances, and therefore an elimination diet and re-challenge are required. Depending on your symptoms, our dietitian can help guide you through a low FODMAP diet, or a food chemical elimination diet. It can be extremely difficult to pinpoint the cause of your symptoms given food contains a variety of different components (both fodmaps and food chemicals). Given the complexities and restrictive nature of these diets it is strongly recommended to work though both elimination and re-challenges with our dietitians, who can then help you to work out a long-term plan to suit your needs.
FODMAP is short for Fermentable Oligo-, Di-, Mono-saccharides And Polyols. They are a group of poorly absorbed carbohydrates, and in susceptible people can cause gastrointestinal symptoms such as diarrhoea, constipation, flatulence, abdominal pain, and bloating. Research has shown that in those with irritable bowel syndrome, eliminating or reducing trigger fodmaps can help manage gut symptoms. The main FODMAPs are fructose, lactose, fructans, galacto-oligosaccharides and polyols and listed below are a very small example of foods these are found in (there are foods high in FODMAPs not included in this list):
Fructose – found in foods such as honey, apples, pears
Lactose – found in most dairy foods
Fructans – found in foods such as wheat, rye and onions
GOS – found in foods such as legumes and cabbage
Polyols – found in foods such as stone fruits and mushrooms
When working with our dietitians, you can expect a plan for eliminating and re-challenging these FODMAPs, and once your triggers have been identified, they will help to liberalise your diet for the long-term. In many cases, people follow the low FODMAP diet for longer than is recommended. This is cause for concern because a low FODMAP diet is typically low in prebiotics which feed your gut bacteria. Without these prebiotics you essentially starve your gut bacteria, often making your sensitivity to fodmaps even worse. Therefore, it is important to move through elimination and re-challenges in a timely manner.
While lactose breath testing is available, recent evidence has shown that breath testing of fructose, sorbitol and mannitol is of little diagnostic value, and therefore you will still need to undergo an elimination and re-challenge protocol to identify your triggers..
Fructose is a naturally occurring fermentable sugar (FODMAP). Excess fructose in foods can cause gut symptoms in some people, such as bloating, abdominal pain, diarrhoea, constipation or flatulence. People that have fructose malabsorption often have other FODMAP intolerances and our dietitian will assess and guide you through a low FODMAP diet if you continue have ongoing symptoms.
Lactose is another naturally occurring fermentable sugar (FODMAP). People who are intolerant to lactose have difficulty breaking down the lactose molecule found in dairy products, causing symptoms such as bloating, diarrhoea, abdominal pain and flatulence. Having lactose intolerance does not mean you need to completely avoid all dairy, and that is why it is important to seek the advice of our dietitian who can help you determine what sources of lactose you need to limit. This is especially important given the nutritional benefits of dairy (important source of calcium and protein). If you continue to experience ongoing gut symptoms then it is likely other fermentable sugars (FODMAPs) may be contributing, and our dietitian can guide you through an elimination and re-challenge process.