FODMAP phase 2 (reintroducing)

[Uncle7]

I’m currently on the FODMAP diet, and for me it’s working great, I’ve had no diarrhoea in 10 days, normal stools with no excessive wiping.

I know at some point I have to start to reintroduce foods to see if any cause a reaction, but my 2 questions are......

1. Why do you have to reintroduce foods, when at the moment, the food I’m eating is doing me good? I’m generally eating food (fruit, fish, meat, vegetables) that have protein, good fats, carbohydrates etc.

2. Can you always stick to the FODMAP diet IF the foods you are eating are balanced? Most of the food on the FODMAP diet that are high, I don’t eat or like anyway (garlic, onion, pulses, etc).

[FRreedman]

It has always been recommended that you use the fodmap diet under the guidance of a dietician, so if you have any diet specific questions, the dietician is the best one to help and advise. The problem is that, with so many of us, our diets are very individual and specific, (what helps me could send you into a flare) which would make it impossible for anyone who didn't know your medical and personal history to advise you with any degree of accuracy.

[asbayford]

I understand exactly what you mean I have completed it with a dietitian and she said I can take as long as I want in the reintroduction. So I just do one thing a month, if it sits well I then incorporate it into my daily low-fodmap diet. It's because fodmaps feed the good bacteria so you need some, and you could be not eating food that you're not intolerant too, so avoiding apples etc because of fructose but you actually only have fructan and lactose intolerances if I want to test something, I make sure I have 3 days free. Do you keep a food/symptoms diary too? I use an app and literally write everything i eat/time/amount. I've spotted intolerances a month later after looking back on it!

[Uncle7 in reply to asbayford]

Thanks for the reply, do you think it was beneficial seeing a dietician? Or, did you already (sort of) knew, what the dietician was going to say or recommend you to do?

I use an app called ‘My Fitness Pal’ as my food diary, as I’m trying to put weight on, so when I have food, I type it in the app and the information is stored (calories, nutrition facts) it’s a great app.

[asbayford in reply to Uncle7]

To be honest, I already knew but there were things she told me that I never knew, so am still glad I had her there seems like every week I'm learning something new about these foods she also gave good advice about calcium and where to get the other vital vitamins. It's all about alternatives on this diet isnt it? Lol

[Uncle7 in reply to asbayford]

May I ask, how many times did you see her? I am going to see a dietician, hopefully I can find a good one.

[asbayford in reply to Uncle7]

I had x3 1 hour sessions with her but you can have as many as you need, I did get the option for more but she agreed i was ready to take it from here

[grufjones in reply to Uncle7]

I had a similar experience. Once I got logging everything in a an App is was much more convenient for me to notice which reintroductions lead to a flare-up in my symptoms. I used Tummi FODMAP for my food and symptom tracker, I thought it was really good. I still use it now if I;m having a dodgy patch.

[Mummy68]

Lucky you !! I am still awaiting an appointment for FODMAP they said they sent one and I didn’t receive it

My gastro dr sent a referral and about a year and half still nothing

It’s just not taken seriously enough in my eyes

I understand there work load is crazy but so is my IBS 🙄🙄

[xjrs in reply to Mummy68]

Have you chased up your appointment and keep badgering them about it? I've had issues with referrals getting lost or not marked as high priority enough. Sometimes you have to make a nuisance of yourself with them to get things moving - normally those who pressure them get there first - shouldn't be this way, but it works.

[Mummy68 in reply to xjrs]

I have chased it up on many occasions but don’t seem to get anywhere tbh I’ve now started to try things myself like eat things see reactions write them down etc !! But then I think I’m ok with things one day and bang another day 💩🤮so I’m sort of hitting a brick wall if that makes sense 😢😢

[Uncle7 in reply to Mummy68]

Not sure if you’ve seen this, but it helped me to clear up a few questions I had regarding IBS.

patientwebinars.co.uk

[Uncle7]

Sorry to hear that, I think I’m some what fortunate that my IBS symptoms aren’t as bad as the ones that people suffer with, after reading about them.

I don’t suffer from bloating or get bad stomach aches and pains, or feel nauseous etc. I just get diarrhoea at least once a week, or at least I did until I started eating gluten free food, I’ve had no diarrhoea in 11 days now.

[IBSNetwork Partner IBS Network]

Hi there,

We always recommend that any exclusion diet is done under the supervision of a registered dietitian.

The diet has three stages. The first stage is reduction of FODMAPs, the second is learning about individual tolerances. The third stage of the diet includes following a FODMAP modified diet longer term, minimising symptoms and increasing diet variety.

For more information visit our website theibsnetwork.org

[xjrs]

One thing to remember is that fodmaps are really good for you, since they feed beneficial bacteria which helps to keep the bad bugs away. Beneficial bacteria have a role to play in overall health include the immune system, other bodily functions and can even influence things such as reducing your risk of cardiovascular disease. It is best to get the guidance of a dietitian. When I completed the inclusion diet I found there were hardly any fodmaps that I could tolerate and I lived like that for years, which was bad for my health and in the end my IBS got worse - I started to suffer from a greater degree of intestinal pain. Note that the good bugs help with things like keeping your intestinal lining healthy. So absolutely you should try to eat fodmaps where you are able.

The official line is that you introduce fodmaps over a 3 day period in increasing amounts each day and wait 3-4 days for symptoms and then wait to be clear of symptoms prior to trying anything new. However I've read scientific papers which say that your body can acclimatize to fodmaps over a period of time since more of the bacteria that can handle that fodmap start to proliferate in the gut. On this basis I have been introducing a very small amount over 2-3 days, whilst recording symptoms and if I can tolerate the symptoms I increase for another 2-3 days, if the symptoms are really bad I cut back to the amount I could tolerate for longer and then increase again. This way I have been able to introduce far more fodmaps back into my diet (whilst being supported with medication and Alflorex probiotic). I've found that in many cases the symptoms improve as my body adapts. There have been things that I've tried even doing it this way that I definitely can't tolerate e.g. psyllium, but more often than not I've been able to add foods back in.