Should you try the low FODMAP diet for IBS?

The low FODMAP diet has been a first line treatment for IBS for some time now. It makes sense, as there are studies showing that about 2/3 of people with IBS get at least some relief from symptoms (constipation, diarrhea, bloating, abdominal pain) while on the diet.

However, it’s not a diet that everyone with IBS should try. Also, my feeling is that experts are not always considering the pros and cons of the diet fully when recommending the diet to patients. When tests come out clear you (usually) get an IBS diagnosis and then the doctor just hands you a piece of paper that goes through the FODMAP diet and expects you to be able to execute the diet without issue.

For one, this is not really the way to fully learn the diet to begin with. It is too complicated to understand from just a handout. 

And for two, not everyone should try the low FODMAP diet. Here is why:

1. FODMAPs don't cause IBS. FODMAPs are small fibers that your digestion can't break down, and so they travel into your large intestine intact and are then digested by your gut microbes instead. This causes gas formation. The thing is that this doesn’t just happen in people with IBS. It happens in everyone, but the difference is that people with IBS have visceral hypersensitivity, which means that they are more sensitive to everything that is going on in the gut, including gas. What you need to work on is to reduce sensitivity, not just to remove anything and everything that could be more difficult to digest. When sensitivity improves, your tolerance to food improves as well. How do you reduce sensitivity? You need to address the root cause of IBS.
2. The low FODMAP diet is a complicated diet that causes stress. We know that stress is detrimental to digestion and gut health, and so anything that increases stress is counterproductive to managing IBS symptoms. This is also the reason why working with a dietitian is important if you do decide to try the diet. You don't want to waste time and effort doing the diet wrong and stressing out about it. 
3. Big diet restrictions, such as the low FODMAP diet, can cause fear toward food. Fear is something that triggers a stress response in the body, and as I mentioned above, stress is really not helpful to your symptoms. If you feel fear toward eating and food, this is your sign to chat with an expert.
4. Removing many foods from your diet increases your risk of nutrient deficiencies. This is another reason why you should always work with a dietitian - they will make sure that you will find foods that will ensure a balanced diet, even with big diet restrictions.
5. When restricting your diet because of gut symptoms, what happens often is that you become more observant of your gut, which makes you more sensitive. Increased sensitivity is again counterproductive to what you're actually trying to do, which is to manage your IBS symptoms better.
6. Very importantly, the low FODMAP diet can change your gut microbiota in undesired ways. There are studies that show that especially Bifidobacteria decrease with the low FODMAP diet and this is again counterproductive to what you are trying to do. Microbiota plays a big role in the gut-brain axis. Negative changes in the gut microbiota negatively impact IBS and the gut-brain axis also.

I don't mean that the low FODMAP diet is never a good idea or that no one should try it. What I am saying is that we should be a lot more careful when we consider the possibility, as it is far from a risk free diet. It might even make your symptoms worse!

If you decide to do it, you always need the help of a dietitian to do it right so that you can stress less and waste less time and effort. Not to mention get actual reliable information from the diet. If you are not doing it right, or if it’s not the right step for you to take (now or ever), you can’t get results from the diet that truly guide you toward food choices that at least won’t make your symptoms worse. 

Also, IBS is now classified as a disorder of gut-brain interaction. While food certainly affect this interaction, it is probably not in the ways that you think it does. What is more important than jumping into the low FODMAP diet is to look at everything else that is going on in your life also. Such as sleep, exercise, rest, stress levels, etc. All these things can have quite the big impact on your digestion, especially sleep and stress.

So, my recommendation is that before you try the low FODMAP diet, check that your diet is balanced in other ways and think about your stress levels and how you are sleeping. When you get those 3 in order, the chances are good that you will feel better without needing to follow a difficult and highly restrictive diet.

Because IBS is such a complicated digestive disorder, it is very useful to chat about these things with an expert instead of trying to manage them on your own. You can save a lot of time and effort when you have a clear road map to follow. Call me for free to find out what that road map might look like for you, just go here to book your free strategy session.

Thank you so much for reading! I hope this was helpful to you. Please be in touch if there's anything else I can do for you.

Whatever you decide to do, don't lose hope - I believe that there's always something that will help you improve your symptoms. Even if it might take some trial and error to find.

Love,

Anna-Kaisa

PS. I have many resources that you can download for free. Did you get them yet? Here’s the “Secret Solution for IBS” ebook for example - it’s filled with useful information to help you better manage your IBS symptoms without the low FODMAP diet.

PPS. Take advantage of your free call! Let’s strategize together and build you a roadmap toward IBS freedom.