Dear All,
In this article, (Gibson & Shepherd), 2009, Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach (http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2009.06149.x/full), the authors state that,
'If the symptomatic response is inadequate, specific questioning is required to determine the adherence to the dietary principles and any deficiencies corrected. If adherence was strict, attention may be needed to modify intake of resistant starch and insoluble and soluble fibre. Other dietary triggers such as food chemicals may need to be considered, as should potential factors such as caffeine, fat, meal size and regularity.'
The ambiguity of the above, with regards to modifying resistant starches, insoluble and soluble fibre, led me to contact a specialist and dietician. I asked her about her thoughts on incorporating the FODMAP approach with the basis of the EFI diet, that is, soluble fibre as the basis of meals, soluble fibre supplements and the careful incorporation of insoluble fibre.
In the reply I received, her thoughts were that the problem with adding soluble fibre is that it is fermentable and therefore the two approaches (EFI/FODMAP) are unlikely to ever co-exist successfully. Her suggestion was to trial the FODMAP approach (without the EFI rules & soluble fibre supplements) and if this fails to consider mediator release testing/LEAP elimination diet.
Does anyone have any thoughts on the above? I'd be keen to hear your opinions/experiences regarding the above.
Best wishes
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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