Irritable Bowel Syndrome Message Boards | Correction .... FODMAP diet works for all IBS subtypes including C

This statement is incorrect "So far there is no study evidence that FODMAPS helps IBS constipation." Here is some research evidence showing it works for IBS-C too.

(1) Check graphs E & D in Figure 2, page 72 to see how IBS symptoms dramatically declined in both IBS-D and IBS-C on a VAS scale when on a low FODMAP diet compared to a normal diet. In the body of the text it says

"Interestingly, of the 70% of subjects who felt better on the low FODMAP diet, this encompassed subjects across all 4 subtypes of IBS"

Halmos, E. P., et al. (2014). "A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel�Syndrome" Gastroenterology 146(1): 67-75

(2) "Initial studies included a retrospective study of the efficacy of the diet, demonstrating that 75% of individuals with IBS had improvement of bloating, abdominal pain, nausea, flatus, diarrhea, and/or constipation when on a diet low in fructose and fructans.33"

"With the osmotic nature of FODMAPs contributing to diarrhea and the fermentation by-products contributing to symptoms of gas distension, the improvements to constipation predominant IBS seen by the FODMAP approach need further exploration. Methane production during fermentation of FODMAPs seems to be a viable option."

Barrett, J. S. (2013). "Extending Our Knowledge of Fermentable, Short-Chain Carbohydrates for Managing Gastrointestinal Symptoms." Nutrition in Clinical Practice 28(3): 300-306.Barrett, J. S. (2013). "Extending Our Knowledge of Fermentable, Short-Chain Carbohydrates for Managing Gastrointestinal Symptoms" Nutrition in Clinical Practice 28(3): 300-306.

(3) "There was a significant positive correlation between adherence and improvement in bloating (rs(83)= 0.273, p = 0.011), abdominal pain/discomfort (rs(87) = 0.271, p = 0.010), flatulence/wind (rs(85) = 0.374, p = 0.000), diarrhoea (rs(72) = 0.310, p = 0.007), constipation (rs(63) = 0.296, p = 0.017) and energy levels (rs(81) = 0.271, p = 0.013)."

"The observation that constipation also improved on a low FODMAP diet may seem counter-intuitive given the proposed mechanism of action for most FODMAPs."

de Roest, R. H., et al. (2013). "The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study" International Journal of Clinical Practice 67(9): 895-903.

This statement is also incorrect "it lumps together gluten, fructose, and lactose intolerances with IBS"

They don't claim that gluten is an IBS trigger. In fact their recent research shows clearly that self-report gluten sensitivity does not exist and gluten is not an IBS trigger . They do show that fructans - a FODMAP and carbohydrate found in wheat, rye and barley is a potential IBS trigger. They do recommend using a gluten free diet because generally speaking gluten free foods are low FODMAP but not always so they warn the user to read the label of gluten free foods to make sure they don't contain high FODMAP foods.

Biesiekierski, J. R., et al. (2013). "No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates " Gastroenterology 145(2): 320-328.e323.

For a discussion on the difference between 'gluten free', 'wheat free' and the FODMAP diet see the Monash University FAQ (this is the GI group that developed the FODMAP diet). In particular see the answer to this FAQ question 5. What is the difference between 'gluten-free' and 'wheat-free' foods? Do I have to restrict gluten?

The FODMAP diet works so well when combined with the removal/reduction of common IBS trigger foods such as high fat, high insoluble fiber, etc that in the UK Kings College London University trains NHS dietitians about the FODMAP elimination/re-introduction diet. Anyone who lives in the UK can ask their GPs for a referral to one of these NHS dietitian for help managing IBS symptoms

Kings College London FODMAP program

For testimonials from a large number individuals with all types of IBS including IBS-C that have had good results using the FODMAP approach for managing IBS symptoms check the following groups on facebook "FODMaPs Support Group UK." and "IBS (Irritable Bowel Syndrome) Support Group".

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STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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