The FODMAPS Approach
FODMAPS is an acronym and it stands for Fermentable Oligosaccharides (eg. Fructans and Galactans), Disaccharides (eg. Lactose), Monosaccharides (e.g. excess Fructose), and Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt).
These are all types of carbohydrates – sugars and starches fermentable by gut flora – and all have certain characteristics in common
They may be poorly absorbed in the small intestine and we therefore need the right levels of beneficial bacteria, in the right places in the gut, to digest them fully
They are the favourite foods of the bacteria which live in the large intestine and in some people in the small intestine too. When bacteria eat FODMAPs, a lot of gas is produced
FODMAPs can act as a sponge by drawing and holding excess fluid in the large intestine
Symptoms typically experienced by sufferers of this type of carbohydrate malabsorption are watery (sometimes explosive) diarrhoea, constipation or both.
Championed by Australian dieticians Jacqueline S Barrett, Professor Peter Gibson and Dr Jane Muir based at the Box Hill Hospital and Monash University, this diet involves avoiding foods containing FODMAPS and helps determine which types of carbohydrate are not tolerated by an individual. A period of exclusion of all FODMAPS before a careful re-introduction of each type of carbohydrate in turn can result in significant relief for some people. This dietary approach is increasingly being used in the treatment of IBS symptoms and is reported to be working well for many IBS sufferers.
Where are FODMAPs found?
A few examples of food sources for each of the FODMAPs are listed below
Foods containing Lactose
Milk, ice-cream, custard, other dairy desserts, condensed and evaporated milk, milk powder, yoghurt, margarine, soft un-ripened cheeses (e.g. ricotta, cottage, cream, mascarpone).
High Fructose Foods
Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup, Corn Syrup Solids
Foods containing Galacto-Oligosaccharides
(GOS):Legumes (eg. baked beans, kidney beans, borlotti beans), Lentils, Chickpeas
Foods containing Fructans
Artichokes (Globe and Jerusalem), Asparagus, Beetroot, Chicory, Dandelion leaves, Garlic (in large amounts), Leek, Onion (brown, white, Spanish, Onion powder), Raddicio lettuce, Spring Onion (white part), Wheat (in large amounts), Rye (in large amounts). Look for Inulin and Fructo-oligosaccharides in lists of ingredients: they are also found in onions, asparagus and bananas.
Foods containing Polyols
Apples, Apricots, Avocado, Cherries, Lychee, Nectarines, Pears , Plums, Prunes, Mushrooms, Sorbitol (e420), mannitol (e421), xylitol (e967), maltitol (e965) and Isomalt (e953).
FODMAPS & IBS Clinics
We use FODMAPS fairly frequently at IBS Clinics as many IBS sufferers have some degree of carbohydrate malabsorption.
Although the diet can initially feel daunting, the personalised guidance we give on meal choices helps most of our clients do very well. In some cases this diet has afforded almost complete symptom relief, whilst others have experienced 40-50% improvement. Further investigations and interventions are warranted for this group of patients.