Irritable bowel syndrome (IBS) affects 1 in 6 people and is characterized by chronic abdominal pain associated with a change in bowel form or frequency. Typically pain or discomfort related to IBS is relieved with bowel movements. Bloating is often a common symptom and one of the many reasons patients come to Gotham Medical Associates. About one third of patients with IBS have a form of IBS in which they are constipated most of the time (IBS-C), while another third of patients have frequent loose stools (IBS-D), the remaining group has mixed symptoms (IBS-M).
The exact causes of IBS are unclear but likely include genetics, environment, stress levels, and diet. If you or someone you know suffers from IBS you may deal regularly with the discomfort of bloating, increased flatus, and irregular bowel movements. All of this can occur despite eating what is considered to be a “healthy diet”. The purpose of this inaugural newsletter is to introduce our patients at Gotham Medical Associates to the FODMAPS, particularly those patients with symptoms of bloating and or those who have been diagnosed with IBS.
What are FODMAPS? FOMDAPS are a group of sugars collectively called Fermentable Oligosacharides Disacharrides, Monoscharrides, and Polyols. These sugars and sugars alcohols vary in size, length and shape. They are ubiquitous in our diet and include the common Disaccharide, lactose, the Monosaccharide fructose, and well as sugar alcohols including sorbitol, xylitol and mannitol. Other less knowns FODMAPS include the fructans, which are longer molecules.
How do FODMAPS cause symptoms? When FODMAPS are undigested, unabsorbed, or over-abundant they reach the colon and are fermented by the colonic bacteria. In the process of fermentation hydrogen gas and lactic acid are produced. This ultimately leads to bloating, loose stools, and abdominal pain. For some, and for unclear reasons, this results in constipation and bloating.
Is Gluten a FODMAP? No, in fact, Gluten is a group of proteins found in wheat. It is hypothesized that ingestion of wheat (containing gluten) results in bloating as a result of coincidental FODMAPS found naturally within wheat.
What is a Low FODMAP diet? The Low FODMAP diet is based on research conducted by the Monash University in Australia. A strict interpretation of the diet would be to exclude all high FODMAP-containing items from the diet for 4-6 weeks and then a “re-challenge” phase whereby foods are reintroduced one-by-one to systematically determine which foods are culprits. This strategy can be restrictive on the diet due to possible excessive dietary exclusions, and the long term risk of FODMAP exclusion is not known, thus it should only be attempted under the guidance of a nutritionist with expertise in this area. Gotham Medical Associates can link its patients up with qualified nutritionist if needed.
Visit Gothammedicine.com for more details on the Low FODMAP Diet.
If you are interested in obtaining a consultation with one of our Gastroenterologists please call 212-227-3688. Our staff will be happy to assist you, your friend or family member!