A note to the low-FODMAP folk

Warning: long post alert! This is something I’ve been wanting to write for a while but waited until my symptoms settled down enough to show me I’m on the right track. Hurrah, they have! So here’s my story . . .

If I scroll through my recent posts, I notice one very big dietary change in the past six months: I now eat FODMAPs. Beetroot, garlic, onions, more than a handful of nuts: things that used to be on the no-go list have entered my food sphere and my gut has never been better.

That’s because for me, FODMAPs weren’t the root cause of my problem. I realise many of my readers may have tuned in because I was posting a lot of low-FODMAP meals and they, too, were on a low-FODMAP diet. Indeed, I was; I was on the diet for years. I learned only later that it’s not meant to be a long-term diet. But I came to this realisation through my own intuition and the timely arrival of a blog post in my inbox, so I know for sure that the message isn’t exactly being widespread. That’s why I wanted to reach out in the hope that anyone in the same boat as I was can find the answers they need to get their gut health back in line.

Here was my situation: I can’t remember exactly when my digestive issues started, but they’d become progressively worse over the years. By the time I was in my teens I often felt sick after eating with no clear link between food (the usual suspects like gluten and dairy, at least) and symptoms. I bounced from doctor to doctor to dietician to any alternative therapist who might be able to help in the hope of finding some relief from my often debilitating stomach pain, diarrhea and the general feeling-like-crap that comes with them.

At some point, I discovered the low-FODMAP diet. At last, some relief! My symptoms decreased for the first time ever, and all I had to do was to cut out some (albeit pretty staple) foods like garlic, onions and apples. Done. I was working with a dietician who ran me through the different phases from elimination to reintroduction. The problem was, I never made it to the reintroduction phase. Every time I would try to challenge a food group, my symptoms would return. My dietician had said that most people only have issues with one food group, occasionally two. I just thought it was bad luck that I seemed to have issues with all of them. Oh well, I thought. I was just glad to be finding some relief in the first place. The diet had become pretty manageable by that point, so I figured this would be it from now on. When I went out for meals, I would stray a little and pay for it the next day, but I felt like I was living a relatively normal life. And at least I wasn’t in pain too much of the time.

Skip forward a few years to the arrival of the aforementioned blog post in my inbox, it’s title: ‘The low-FODMAP diet is not a forever diet!’ I wrote a post at the time about why I decided to investigate further, but it lead to a diagnosis of dysbiosis (which has lead to other issues, such as hypothyroidism). From that point on (six months or so ago), I could actually start healing my gut.

Don’t get me wrong, it’s a bloody hard process. I didn’t see any progress for the first three months (after a rough year of trying even more diets like SCD – which made my symptoms much worse – and having even more tests for things like Crohn’s Disease) and at times I wondered if FODMAPs still were an issue for me.

But I now know the reason I had less symptoms on a low-FODMAP diet. FODMAPs are a group of dietary sugars that are poorly absorbed in the small intestine and fermented by bacteria to produce gas. Tests showed I had little to no visible growth of the three main strains of beneficial bacteria (Lactobacillus, Escherichia coli and Bifidobacterium) needed to break down any food. The fact that FODMAPs are often more poorly digested and more fermentable just made them even worse for me. It also made sense that my symptoms improved on the low-FODMAP diet but never disappeared.

The key test that lead to my diagnosis and helped to shape my gut-healing process was a comprehensive stool analysis, such as this one. This helped my doctor to ascertain what we were dealing with and therefore how to treat it: which bacteria were low, whether there was any overgrowth of unwanted bacteria, and so on. Until then, my ‘treatment’ from the various other medical professionals I’d dealt with had been trial and error – a lot of error. It was so relieving to be able to understand my particular situation. And please remember that everyone’s situation is different.

Now, I’m not saying that the low-FODMAP diet isn’t the answer for anyone. I’ve heard that it’s helped a lot of people, and that’s great. Maybe some of those people really did just have an issue with fructose, lactose or one of the other FODMAPs, and cutting it out was enough. But I’m really curious how many people are radically restricting their diets when there’s an underlying issue going on – one that can potentially be healed.

An issue for those with dysbiosis is that a low-FODMAP diet is also a low-prebiotic diet. Prebiotics are foods that contain the fibre on which friendly bacteria feed and include garlic, onions, leeks, asparagus and artichokes – yep, all high-FODMAP foods.

I’m also not a doctor, of course, so please don’t take my guidance over the advice of medical professionals. I did, however, go through many different medical professionals until I found someone who knew what they were dealing with. If your situation sounds like mine, I urge you to find a professional who has dealt with cases like this before. My main advice is to go with your gut (however untrustworthy it may seen when you have digestive issues!). I promise you, it’s worth it.

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