“What we eat determines how well our Digestion Works.“
Although it is an uneasy conversation, approximately 10-15 percent of the population has issues with abdominal pain, bloating, diarrhea, and constipation known as Irritable Bowel Syndrome (IBS). Dietitians discuss it often with our patients, and it always leads to food intake.
Women report three times more IBS symptoms than men as the problem presents by the many “Pepto Bismol” commercials I am witnessing. Clinicians refer to the condition as Functional Gut Disorders (FGDs). The word Functional is used as it pertains to an occurrence where the “Function” or Movement of the bowel is not quite right. Evidence-based research shows that what we eat determines how well our digestion work. Digestion is the process of breaking down food by mechanical and enzymatic action in the intestines into nutrients that can be used by the body.
Research conducted by Dr. William Chey, Professor of Internal Medicine, University of Michigan, sustains that specific compounds found in various foods known as FODMAP are responsible for IBS. FODMAP is an abbreviation for a group of short chain sugars that are unable to be broken down/digested in the intestines because the body lacks the required enzymes. The undigested sugars remain in the colon/gut and in turn starts to ferment changing the bacteria flora and drawing excess water into the colon resulting in GI symptoms of cramping, abdominal distention (bloating), gas, constipation/diarrhea (IBS).
FODMAP Identified: F-fermentable O-oligosaccharides (fructans, galactans) D-disaccharides (lactose) M-monosaccharides (fructose) P-polyols (sugar alcohols)
Let’s take a quick recap of the FODMAP Diet
Fermentable: The fermentation of undigested sugars in the colon as previously stated the microflora (bacteria) within the colon starts to feed on undigested sugars creating an environment for osmotic diarrhea, gas, pain and abdominal bloating-IBS.
Oligosaccharides: Fructans (fructose-fructose) are compounds found naturally in plants. Fructans are held together by a bond requiring a specific enzyme to separate them for absorption within the body. Humans unfortunately lack the enzyme required to break the bond which results in large amounts of undigested Fructans passing through the colon, causing bloating, gas and cramps. Wheat contains Fructans and may cause symptoms of IBS.
Galatians are compounds found in plants as well but are made up of long connecting chains of galactans held together by bonds. As with Fructans, the body lacks the enzyme to break the bonds resulting in undigested galactans passing through the colon. Galactans are found in lentils, chickpeas, kidney beans, black-eyed peas, broccoli, and soy-based products and may cause IBS.
Disaccharides-Lactose is known as a Disaccharide found in human, cow’s, sheep’s and goat’s milk consist of two (di) sugars (glucose and galactose) requiring the enzyme “lactase” to break them apart for digestion/ absorption. “Lactose Intolerant” Individuals lack the enzymes lactase, thus, as lactose flows to the colon undigested resulting in bloating, pain, gas, and diarrhea (IBS). Symptoms usually occur 30 minutes to two hours following milk consumption.
Monosaccharide-Fructose and glucose are two monosaccharide found in fruit (glucose and Fructose/fructans), the body can digest fructose relatively well except for certain foods which contain more fructose than its glucose counterpart, the body cannot efficiently digest fructans. Apples, pears, mangoes, and Agave are higher in fructose/fructans may cause IBS symptoms.
Polyols-are sugar alcohols in fruits and vegetables used as a sweetener for sugar-free foods such as gums, mints, cough drops, and diabetic desserts. Due to their large size, are unable to diffuse out of the small intestines which creates a laxative effect on the GI tract resulting in diarrhea. Sources: sorbitol, xylitol, and mannitol (mannitol most severe impact).
If you are experiencing severe symptoms of IBS where it is disrupting your quality of life, make an appointment with a Gastroenterologist (GI) for proper assessment and treatment. The FODMAP Diet works, however, requires a GI and RD to guide you through the process, the goal is not to eliminate all of the FODMAPs but to identify and minimize those that cause the most problems.
Recap on the FODMAP-You are what you eat.