Low FODMAP Diet

[IBS-]

Hi,

Could you anyone suffering with IBS-C recommend a good low FODMAP Diet book.

Many thanks,

[Hidden]

I've been under an NHS Dietician (UK) and was given a booklet to start with. If you want recipes the internet is the best place to go.

It's every hard diet but believe you me it's worth it, I feel 100 times better.

I'm now at the tailor your diet stage ie. I've done the reintroduction stage.

Very best of luck but please message me if you need to know anything.

Take care

[IBS- in reply to Hidden]

Thank you that’s really good to hear! I’ve only made the decision today to start it based on research and I already have made better choices with my food and have made a good start - I’m excited! It’s really good to hear positive feedback. Just out of interest, what are your main triggers?

[Hidden in reply to IBS-]

Oh well done on making that decision, I'm so pleased you've made a good start.

My triggers are: barley (very bad), onions, peas, pea protein, dried mango, mushrooms, garlic, butternut squash, nectarines. I had no reaction to spelt pasta, beetroot, raisins, sultanas, leek, dried apricots, sweet potatoes and my homemade spelt sourdough (best recipe for this is on the Doves Farm website.

I've got the Monash FODMAP and Kings College apps but the Monash one is much better.

[IBS- in reply to Hidden]

Thank you! That’s good to know. May I ask if it helped with bowel movements? I suffer terribly with constipation so I am praying that this eases when I’m following the low FODMAP diet, fingers crossed

I’ve also just bought the Alflorex and took my first one today!

[Hidden in reply to IBS-]

I had IBS D when I started so didn't have that problem but for me personally after about day 3 I felt absolutely amazing. Before I had food poisoning in November 2018 I had IBS C and used to have a tablespoon of golden linseeds in about half to a full mug of water. Let it soak for around 5 minutes and it's like a gel consistency, that's when you drink it. Make sure you drink lots of water with it.

Well done, I've just ordered some today.

[IBS- in reply to Hidden]

Thank you very much!

[xjrs]

If you are in the UK you can get a GP referral to a FODMAP trained dietitian and they tell you how to do it and provide you with booklets including recipes.

One thing to be careful about with IBS-C is that low FODMAP tends to reduce residue going into your colon, which could make constipation worse. When I was low FODMAP I needed to consume loads of oatbran and seeds etc, plus add in cellulose powder as a fibre supplement.

Many people who need to be low FODMAP may have a gut bacterial imbalance and it might be worth trying a good probiotic such as Alflorex prior to going low FODMAP since it may make you tolerant to more foods. I wish Alflorex was available years ago since I wouldn't have had to be on a restricted diet for so long. Here is some information about IBS that I have shared with others in this group which includes information about this:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/....

This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[IBS- in reply to xjrs]

Thank you very much - very informative and great knowledge!

[Hidden in reply to xjrs]

Hi xjrs

I've just read your response with the greatest of interest and in particular what you have said about Alflorex.

I've been following the Low FODMAP diet now under a Dietician through the NHS since early January and I'm at the stage now where I'm trying to tailor my diet. There were quite a few foods I couldn't tolerate so I'm going to have a look at the Alflorex, originally I was going to go down the Digestive Enzymes route so thank you for this.

I'm so glad you are much better and I have to say following the Low FODMAP diet has been the best thing ever for me.

Alicia

[xjrs in reply to Hidden]

Good to hear from you Alicia. So great that Low FODMAP has worked for you. Aflorex is definitely worth a try. I did try enzymes myself, but they made my pain worse - even at low dose - I've read that enzyme deficiency is quite rare. You could maybe give Alflorex a go for a couple of months and then try to introduce some of the foods that you couldn't previously tolerate in the method I described. It's a long old process but worth it in the end. I must say that my IBS moved from 'D' to 'C' over the years and the main presenting problem I had was pain which I also got assistance with by taking Linaclotide. However I'm unsure at this stage if I'd taken Alflorex first, whether I would have needed Linaclotide. Everyone's make up is different though and IBS has so many root causes - it's certainly worth trying remedies specific to your symptoms in case you come across something that works for you. Good luck with it - I really hope it helps you - fingers crossed!

[Hidden in reply to xjrs]

Thank you. The Low FODMAP diet is amazing and I've been so fortunate that it's worked for me. I've looked at Aflorex and the feedback is very good. I get the IBS D rather than pain these days, I used to get IBS C but food poisoning in November 2018 changed it to IBS D and acute nausea hence going on the diet.

I'm definitely going to give them a go and then slowly but surely reintroduce other foods and I agree that the process is very long but so very worth it. I had some pain today but it's not very often now but when I do get it I take good old paracetamol as I was fed up spending out on Buscupan and other supposed IBS pain relievers that didn't work at all for me.

Yes IBS does have a lot of root causes and mine was food poisoning in 1996 originally and the second bout as I've mentioned above. I'll report on here how I get on.

Thank you

[xjrs in reply to Hidden]

Yep, that's how mine started too - food poisoning from a trip to Mexico. This means that some bad bugs in the gut is potentially one of the root causes for us.

[Hidden in reply to xjrs]

You don't realise how much impact food poisoning can have on your life. The first time round I coped absolutely fine and for many many years but the second time I was getting acute nausea most days and couldn't function.

I've just ordered the Aflorex.

[xjrs in reply to Hidden]

Ah - I should have mentioned that if you join theibsnetwork.org just before the end of August for £24 for the year, you can get 2 months of Aflorex for free (effectively £12 / month). It is still possible to do this though on top of what you ordered. Doh - I should have mentioned it. You'd need to get in quick, though. They send you the first back and then you have to call them to tell them how you are doing, then they send you the second pack.

[Hidden in reply to xjrs]

It's ok, I'm already a member so I doubt I'd get the offer but I'll see if there's a members' offer.

£12 a month sounds cheap, where do you get yours as what I've ordered is dearer?

Thank you.

[xjrs in reply to Hidden]

Sorry. I meant if you join theibsnetwork.org, the membership costs £24, so if you hadn't planned to join and only wanted the Alflorex then you've only spent £24 and got your 2 months (i.e. £24 / 2 - £12). I get mine from Precision Biotics and yes it is very expensive. The cheapest way of getting it is their 2 month pack. They have a 3 month trial pack but they only let you have that once (which works out about £16 per month) - since you haven't done any kind of trial with them yet and if you get on with the first month OK, you should be able to order the 3 month pack once. However it is a lot of money up front. It would be good if so many people bought it then the price comes down, but they told me the reason it is so expensive is that they have to pay for the scientific studies that have been done on it.

[Hidden in reply to xjrs]

Ah, I see what you mean. That's funny, that's who I've ordered from and got the 3 month supply.

I see why it's expensive but agree if more people bought it it would be cheaper.

[S969]

There are some good apps you can download such as Monash . Really helpful for doing a quick check.. I also printed out a table of high/ low fodmap foods and use the internet for recipes or just adapt old familiar recipes

[Meeowla]

Hi there fellow IBS C sufferer!

Yes I can recommend alittlebityummy.com. Stumbled across this and have been pleasantly impressed and use the same recipes for my husband too!

[LoveSoCal]

I found The Complete Low FODMAP Diet by Dr Sue Shepherd and Dr Peter Gibson to be absolutely excellent. I highly recommend it. Also very good are The Low FODMAP Recipe Book by Lucy Wigham and IBS for Dummies.