Sunday, 20 April 2014

Resolving gluten sensitivity: Fodmaps and your gut

Those sensitive to gluten may improve their symptoms by avoiding the carbohydrates known by their acronym, Fodmaps.

Coeliac disease, which is basically the result of the body’s inability to digest gluten, and gluten sensitivity are gaining more and more attention.

But, for many with symptoms – gas, pain, bloating, cramping, constipation or diarrhoea – gluten may not be the issue, or may only be part of the problem.

In true coeliac disease, a person cannot digest gluten – a protein found in wheat, rye and barley.

Lifelong adherence to a gluten-free diet is the only management for this condition.

For those with gluten sensitivity, irritable bowel syndrome or functional gut disorders, eliminating gluten may not resolve the symptoms completely.

These individuals may be responding to fermentable, oligo-di-monosaccharides and polyols (Fodmaps).

Okay, now that you have swallowed that mouthful, let’s break it down.

Fodmaps are short-chain carbohydrates, actually sugar molecules, which are poorly absorbed in the intestine.

They are osmotic, which means that they pull water into the intestinal tract that in turn, leads to bloating and diarrhoea.

They may also be fermented by bacteria in the gut, which also leads to gas and bloating.

The response to Fodmaps is very individual, and it requires some effort to determine individual triggers.

So, what exactly are Fodmaps?

They can be categorised as the following:

·Fructose – found in high amounts in some fruits (watermelon, pineapple, oranges, honeydew melon, peaches, starfruit, mango, apples and pears), honey and high-fructose corn syrup.

·Lactose – milk sugar found in most dairy products (all types of milk, ice cream, custard, yoghurt and soft cheese such as ricotta and cottage cheese).

·Fructans – also known as inulin and found in wheat, onions, garlic, zucchini, mango, persimmon and watermelon.

·Galactans – found in beans, baked beans, green beans, lentils, cabbage and brussels sprouts.

·Polyols – found in low-calorie sweeteners such as sorbitol, mannitol, isomalt and xylitol, and in some fruits such as apples, pears, apricots, cherries, nectarines, peaches and plums.

Resolving gluten sensitivity

A low Fodmaps diet may help to resolve symptoms that have not been resolved by simply eliminating foods containing gluten.

To try this approach, you need to avoid all Fodmaps food for at least six weeks.

This is not easy because so many foods are restricted.

It would be wise to do this elimination diet with the help of a registered dietitian or gastroenterologist.

Those who are sensitive to Fodmaps usually see resolution of symptoms in one to two weeks.

The next step is to slowly reintroduce Fodmaps foods one category at a time to see if symptoms reappear.

Many hesitate doing this step once they are feeling better. But it is important because not everyone responds to every Fodmap.

In many cases, a person simply needs to limit, rather than eliminate foods.

Symptoms are often due to a dose response. In many cases, a person can eat a reasonable portion (half a cup) of a food, but eating more may trigger symptoms.

Although it may appear complicated, once triggers are found, it is easy to avoid them.

Following a low Fodmaps diet, once individual triggers are determined, is quite safe.

There are many gluten-free options currently on the market, as well as many alternative choices for foods that must be avoided.

Important to the success of implementing a low Fodmaps diet is the education you receive from a dietitian or doctor.

It takes considerable time to examine a person’s diet and identify potential triggers.

It is also important that you understand and can identify alternative foods that are allowed.

Compliance with the diet and its ultimate success will be spotty without a qualified health care provider for support. –

>> Jo-Ann Heslin is a registered dietitian from the United States.

Tags / Keywords: Health , Coeliac disease , gluten free , fodmaps , diet


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