What is a FODMAP diet and what symptoms does it treat?
8/20/2020 by Stephanie Hansel, MD, MS
FODMAPs are poorly absorbed, fermentable, short-chain carbohydrates that are commonly found in our diet. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. It has been proposed that a diet high in FODMAPs can produce gastrointestinal symptoms including diarrhea, constipation, bloating, gas and abdominal discomfort or pain. The symptoms are common in patients diagnosed with irritable bowel syndrome (IBS).
What are examples of food high in FODMAPs?
Foods high in fructose include apples, pears, watermelon, asparagus, sugar snap peas, fruit juices, dried fruit, high fructose corn syrup, and honey. Foods high in lactose include custard, ice cream, milk, cheese, and yogurt. Polyols are found in apricots, nectarines, peaches, plums, cauliflower, and sorbitol. Brussels sprouts, garlic, onion, rye, and wheat are examples of fructans. Finally, chickpeas, legumes, lentils, pistachio nuts, and cashews are examples of galactans.
How do I follow a low FODMAP diet?
It is best to meet with a dietitian and discuss how to start a low FODMAP diet.
- Step 1 (the elimination phase) of the diet involves changing from high FODMAP foods to low FODMAP foods for a period of 2-6 weeks.
- Step 2 (the reintroduction phase) of the diet focuses on the reintroduction of FODMAPs into your diet. One FODMAP should be reintroduced every 3 days. This process of reintroducing foods can take 8-12 weeks.
- Step 3 (the maintenance phase) is the personalization phase of the diet. In this phase, you work on finding the balance between FODMAP rich foods and low FODMAP foods.
Does this diet help everyone with IBS?
Unfortunately, a FODMAP diet will not help everyone diagnosed with IBS. It may help to decrease some of the symptoms of IBS such as bloating, gas, abdominal discomfort and possible diarrhea.
Where can I learn more about a low FODMAP diet?
There are several resources available for patient education on FODMAP:
- The Low FODMAP Diet Approach: Dietary Triggers for IBS Symptoms (International Foundation for Gastrointestinal Disorders [IFFGD])
- My Nutrition Health (University of Michigan)
- Starting the FODMAP diet (Monash University)
What if a low FODMAP diet does not help me?
If you fail to improve on the FODMAP diet, it is important that you reintroduce foods and liberalize your diet. A low FODMAP diet is not meant to be a long-term diet for anyone. The long-term goal of this diet is to find balance between symptomatic improvements without having negative effects on your nutrition.
Dr. Stephanie Hansel is a gastroenterologist at Mayo Clinic in Rochester. She completed her MS at North Dakota State University, her MD at the University of North Dakota School of Medicine and Health Sciences, her Internal Medicine residency at University of Nebraska Medical Center, and her gastroenterology fellowship at Mayo Clinic in Arizona. Her interests include general gastroenterology, endoscopy, and medical education.