see also:

• irritable bowel syndrome (IBS)
• healthy living and diets
• Monash University - FODMAP diet and smartphone apps
• http://www.npr.org/blogs/thesalt/2014/05/22/314287321/sensitive-to-gluten-a-carb-in-wheat-may-be-the-real-culprit?ft=1&f=139941248

• many gastroenterologists now believe that excessive levels of FODMAPs in the diet in at risk persons leads to symptoms of irritable bowel syndrome (IBS), and that reducing the level of FODMAPs in their diet, although a very restrictive diet, can help substantially reduce the symptoms of bloating, constipation, cramps, etc.
• in other words, at risk persons do not have the enzyme capacity to fully digest these FODMAPs and thus they are fermented by gut bacteria leading to excessive gas production, cramps and other symptoms.
• these persons are not “allergic” to FODMAPs but theory suggests that by reducing the intake one will have less undigested FODMAPs entering the bowel.
• the low FODMAP diet was designed by a team of scientists at Monash University in Australia led by Peter Gibson and Susan Shepherd who linked FODMAPs to IBS in 1999
• testing for FODMAP sensitivity is still controversial and is not yet subsidised by Medicare
• there are significant issues with adopting very restrictive diets such as a low FODMAP diet, and so this should be done in consultation with a specialist, these issues include:
  • eating gluten-free processed foods which are generally high in sugars and fats to make them edible
  • these diets expose risk of inadequate essential nutrient intake
  • more expensive foods (eg. use of spelt flour)
  • potential that eradication of FODMAPs may actually result in reduced level of gut enzymes and thus increased sensitivity to dietary FODMAPs if they are eaten.
  • social and family impacts of restrictive diets

• FODMAP is an acronym for Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides And Polyols
• these include:
  • fructan
    • found in wheat, garlic, artichokes, etc
    • in general, the easiest way for patients to avoid fructans is to eat gluten-fee foods, hence the new fad for gluten free diets even in those who do not have true coeliac disease
  • fructose - found in many fruits
  • lactose - found in milk and dairy products
  • galactans - found in many legumes