Irritable Bowel Syndrome: A low FODMAP diet for symptom relief

People with Irritable Bowel Syndrome tend to be more sensitive to the effects of FODMAPs. FODMAPs are poorly absorbed carbohydrates that can cause abdominal symptoms.

Do you suffer from abdominal discomfort without any known cause? You are not alone. According to the U. S. National Library of Medicine, one in six people in the U.S suffer from symptoms of Irritable Bowel Syndrome (IBS), and women are twice more likely than men to be diagnosed. IBS is a functional disorder in which the GI tract does not become damaged but symptoms are caused by changes in how the GI tract works. It is not clear why people develop IBS but it is believed to have both physical and mental causes.

It is diagnosed with abdominal pain/discomfort that lasts at least three days a month for the last three months without a known cause. Symptoms can include the following: Bloating, reflux, excess gas, abdominal pain, nausea, diarrhea, constipation, flatulence and fatigue. Symptoms can range from mild to severe and it is common for symptoms to be present often or get worse for a few weeks and then decrease for a while. The discomfort of IBS can usually be relieved by a bowel movement. It is important that you work closely with your doctor in order to rule out more serious causes for your symptoms before IBS is diagnosed.

IBS can be a lifelong condition and symptoms can be debilitating for many by reducing their ability to work, travel and attend social events. Recently, high FODMAP foods have been investigated to possibly be the cause of symptom development.

FODMAP stands for fermentable, oligosaccharides, disaccharides, monosaccharides and polyols. These are short-chained carbohydrates that are poorly absorbed in the small intestines causing discomfort and bloating. This occurs because FODMAPs are osmotically active; this means they pull water into the intestinal tract and as large amounts of FODMAPs are fermented in the gut, symptoms can develop in people sensitive to these effects, such as those with IBS.

There are five categories of high FODMAP foods to include the following:

  • Fructose: Fruits, honey, high fructose corn syrup
  • Lactose: Dairy foods
  • Fructans: Wheat, onion, garlic
  • Galactans: Lentils, legumes
  • Polyols: Sweeteners containing sorbitol, mannitol, xylitol, maltitol and stone fruits

There has been some success in relieving symptoms of IBS in people that limit some of these foods. However, a low FODMAP diet can be difficult to follow – low in fiber and limiting in some essential nutrients. Michigan State University Extension recommends you work with a registered dietitian in order to help customize a diet plan that works best for you.

Most dietitians will recommend eliminating high FODMAP foods for four to six weeks, but you will usually see symptom improvement within one to two weeks. As you work with your registered dietitian, high FODMAP foods will be slowly reintroduced separately, in order to pinpoint offending foods. It is beneficial to keep a food diary during this reintroduction phase since it is common to have immediate symptoms with certain foods. Stanford University Medical Center provides a handout of Low FODMAP foods and tips on how to incorporate a low FODMAP diet into your lifestyle.

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