I grew up in a family with my four brothers, so there was always a lot of “potty talk.” Burping, farting, and talking about the like were always fair game...even at the dinner table. So I’ve always been comfortable with talking about the bathroom...and what goes on in there. After suffering intermittently for 20 years, I am well qualified to talk about diarrhea, constipation, and everything in between. I once jokingly told a client that I am a “certified poopologist!” If your eyes are the window to your soul, then your poop must be the window to your health.
I have been to my fair share of specialists. The first time I saw a GI specialist I was only 22 years old and he said I had the “youngest sigmoid colon” he had ever seen. Uh, Thanks...I think? When my primary care doctor dismissively stated that I must have IBS, she didn’t talk to me about diet or offer me any other solutions. She didn’t even offer me medication because at that time (2001) it wasn’t yet common practice to prescribe antidepressant medications for IBS. Irritable Bowel Syndrome has no specific blood test or diagnostic imaging. So any gastrointestinal imbalance, diarrhea or constipation can be called IBS. There are 2 main types of Irritable Bowel Syndrome: IBS-D (diarrhea) and IBS-C (constipation). And of course, you can be lucky enough to swing between either diarrhea and constipation---which is true for me.
Symptoms of IBS have a lot of crossover with other digestive disorders. It is definitely worth seeing a specialist and getting imaging or scopes.
Symptoms of IBS-D and IBS-C include pain, cramping, diarrhea, constipation, alternating constipation and diarrhea, changes in bowel movements and consistency, gas, bloating, fatigue, anxiety, depression, and sleep disturbances.
It wasn’t until 15 years later when I was seeing another GI specialists, that I was offered the FodMap diet. This time I was getting barium x-rays and a full colonoscopy. After those showed nothing but inflammation and possible lesions forming in my ileum, his best advice was to try the Fodmap diet and do a food journal.
The Fodmap diet plan should really be called the Low Fodmap diet, because you are avoiding foods that have high Fodmaps (fermentable, oligo-, di-, monosaccharides and polyols). If those words make you shudder and run for a consultatory bag of chips, you are not alone. “Fodmaps” is a strange word, and fermentable, oligo-, di-, monosaccharides and polyols are just plain overwhelming to think about or even say out loud.
If you don’t have diarrhea or constipation, then don’t even worry about a Low Fodmap diet. But if you are one of 70,0000 people that do have these issues, then understanding the definition of a Low Fodmap diet is beneficial. At the very least, take a look at this list of high Fodmap foods to see if you recognize any foods that trigger constipation or diarrhea for you.
What are Fodmaps?
Fodmaps (fructo, oligo-, di-, monosaccharides and polyols) are carbohydrates in natural foods. For people with IBS or other digestive issues, these types of carbohydrates are not digested correctly which causes gas, bloating, pain, and diarrhea or constipation. For unknown reasons, some people have an intolerance to these types of carbohydrates. Most people eat foods with Fodmaps every day and have no problems and experience no side effects. But for those of us with IBS, going on a Low Fodmap diet can keep us out of the bathroom.
Fodmap are carbohydrates molecules. Usually when someone says “carbohydrates,” you think of pasta, chips, or cookies. I’m talking about carbohydrate molecules that you can’t see with your naked eye. For example, all vegetables have fiber. And fiber, as it turns out, is actually a collection of carbohydrate molecules. And although broccoli is a vegetable it has a pretty high amount of fructose carbohydrate molecules, which is why broccoli is on the High Fodmaps Food List.
A normal part of digestion involves water entering your small intestines in response to the foods you eat. But in IBS sufferers, this process happens either too slowly or too quickly which results in pain, cramping, gas and bloating.
Short of becoming a food scientist or nutrition nerd like me, it is pretty hard to tell which foods will have high or low Fodmaps. You can take the easy and somewhat controversial route or trying the carnivore diet, or, you can simply download the Fodmap app (hey that rhymes!) and learn as you go. Monash University was the originator of the Fodmap diet and you can find various downloadable pdfs with food lists. According to the studies, Fodmap works for 75% of IBS patients who try it. That is a pretty good track record and definitely worth the hassle, especially if you are visiting the toilet 13 times per day, or not visiting at all for weeks at a time.
What You Need to Know About FodMaps
One of the downfalls of the low Fodmap diet is you can feel worse before you feel better.
If you scour the internet for all things Fodmap and get overwhelmed by the plethora of conflicting information, you may end up hopeless and depressed. By the way, close to 40% of people with IBS also suffer from depression.
Also, if you find that many of your comfort and go-to foods are on the high Fodmap list, you may end up with very limited food choices. That can lead to under-eating, low blood sugar, and a hangry (hungry + angry) version of you.
Here’s another ingredient to throw in: if Fodmaps are natural carbohydrates, fibers, and sugars found in whole foods, we know that they don’t actually cause your IBS. Most of the population can eat these types of foods every day without a digestive problem. So what does cause you IBS? That is a good question, and a likely answer is SIBO (Small Intestinal Bowel Overgrowth).
SIBO occurs when bacteria from your large intestine migrate to your small intestine. These bacteria should only be in your colon and ferment food at a later stage in your digestion. But instead, they are in the top of your digestive tract and start the fermentation process too early. This leads to the gas, bloating, belching, you experience within 30 minutes to 2 hours after eating. Often SIBO causes fatigue, brain fog, anxiety, and depression.
When you eliminate high Fodmap foods, you are also eliminating foods that feed SIBO. When you starve the bacteria in your small intestines, you will likely experience die-off side effects that are very similar to IBS symptoms. So whether your IBS symptoms are caused by too much water in your colon, or by SIBO, you will find some degree of relief from a low Fodmap diet plan.
If I were to create a universal plan to address IBS, it would start with a Whole30. You must be on a whole food diet to take control of your IBS symptoms. After those food habits are put into place, remove all high Fodmaps for a trial period of 3-6 weeks. Then reintroduce high Fodmap foods by category. I am well aware that this process is overwhelming, especially if you are suffering from IBS and its partners in crime---depression, and anxiety. And that is what I am here for. I will coach you through each phase of this journey. We can start from the beginning and go as slowly or quickly as you want. Whole30 and the low Fodmap diet are several important tools for addressing digestive disorders, depression, and anxiety.