The Low FODMAP Diet
Irritable Bowel Syndrome (IBS) is a functional bowel disorder, of which the cause is not yet fully understood. However diet, lifestyle and socio-economic factors are currently considered to have a contributing role towards ongoing symptoms. Treatment of IBS can include a variation of medication, lifestyle changes and diet therapy. Currently a diet therapy known as the low FODMAP diet (first developed in Australia) is now a renowned therapy in the management of IBS in the UK and is available at London Bridge Hospital. The low FODMAP diet has a well defined mechanism of action and also has accumulating evidence – based efficacy.
FODMAP is an acronym referring to Fermentable – Oligo-, Di-, Mono-saccharides and Polyols, which are groups of short–chain carbohydrates and sugar alcohols (polyols), which consist of fructans, galacto-oligosaccharides (GOS), polyols, fructose and lactose. FODMAP’s can be found within our daily diet, and, in susceptible individuals may not be well tolerated on consumption leading to the onset of bowel symptoms. These symptoms may have resulted from the actions of FODMAPs on ingestion i.e. poor absorption, rapid fermentation or an increased pull of fluid within the bowel.
The low FODMAP diet involves the restriction of FODMAPs from a patient’s diet for an eight week period. This temporary restriction can be effective in improving a patient’s bowel symptoms within the first few weeks on initiating the diet, however patients must allow up to eight weeks for the diet therapy to take full effect. Throughout the eight weeks, a patient’s dietitian will provide ongoing encouragement and support. It is the dietitian’s aim to ensure that each patient can achieve a varied and well balanced diet, despite the restrictions that will also be recommended to help induce symptom relief. As well as discussing the mechanism behind the diet therapy a dietitian will ensure that each patient is able to have a varied diet and have the confidence to read food labels, eating out and cook at home whilst following the diet therapy.
On completion of the eight week diet therapy, a dietetic review is carried out to reassess the patient’s bowel symptoms and dietary intake. On symptom relief the reintroduction phase can begin, which is an important aspect of this diet therapy. The reintroduction phase enables patients to identify the FODMAP rich foods that are aggravating their bowel symptoms (‘food triggers’) and in the long term will prevent patients continuing with any unnecessary food restrictions.
During the reintroduction phase foods are introduced at recommended amounts over a three day period. A dietitian will teach the systematic reintroduction process to patients, and provide support throughout.
Since London Bridge Hospital has offered the low FODMAP diet, 73% of all patients to complete the diet therapy have reported satisfactory relief from their IBS symptoms.
For more information on the low FODMAP diet, please call the Dietetics Department on 020 7234 2282.