Tuesday, November 8, 2011
Could FODMAPs be related to GP?
Recently, however, it seems to be popping up everywhere and I'm getting more and more information that justifies a significant link to IBS (which many doctors are now considering), that are also similar to the main symptoms of GP.
What are FODMAPs?
Fermentable Oligo-, Di- and Mono-saccharides and Polyols refer to the short-chained carbohydrates and sugar alcohols found in many common fruits, vegetables, sweeteners such as honey, milk (lactose) and grains, including wheat and rye.
Why can they cause problems?
When foods containing FODMAPs are digested by those who are intolerant are not absorbed by the small intestine and instead provide substrate for rapid bacterial fermentation. This in turn creates gas and expands the volume in our digestive tract, literally distending and creating the symptom we know as bloating. The increased volume and bacterial growth lead to a number of digestive problems.
What are the signs of FODMAP intolerance?
Bloating, diarrhea and/or constipation, stomach pain and spasms, vomiting, flatulence, depression and fatigue.
What really intrigued me was an article I read relating SIBO (small intestine bacterial overgrowth) to gastroparesis, which can be caused overtime by the volume of bacteria increasing in the gut. In the study they found 60% of the patients with GP to also test positive for SIBO. For details read the article at http://www.ncbi.nlm.nih.gov/pubmed/20027008.
Now for the hard part, the FODMAP diet. After years of trying what I thought was elimination overload I feel like I'm up for any challenge. If course, easier said than done. There are many lists out there with what foods are "good" and "bad" so feel free to do your research. Kate Scarlata, author of The Complete Idiots Guide to Eating Well with IBS, wrote a fantastic article relating FODMAPs to IBS called Successful Low-FODMAP Living and can be very helpful in understanding where to begin. Here is a list that is reliable and up to date: http://blog.katescarlata.com/fodmaps-basics/fodmaps-checklist/
There are doctors and dietitians that can run a test called hydrogen breath testing. They are hard to find but I did have some luck in Seattle and plan on getting tested soon*. In the meantime I am trying to limit my intake of FODMAPs and have already noticed a decrease in some symptoms, especially related to garlic, onions, apples and pears.
My Journey Challenge! Follow the food guide above eating only Safe to Eat foods for 3 days and see if you notice a difference. Keep a food diary and note how you feel when eating FODMAP foods after 3 days. If you have positive results then extend to 7 days and then 30. It's possible some foods may be re-introduced with less irritation down the line so if it works don't give up!
Lets help each other. Please comment if you think this might be related to GP or if you have any experience with FODMAPs.
Also, a good additional link to read: http://online.wsj.com/article/SB10001424052970204554204577023880581820726.html
Thank you for reading and I hope this reaches out to those looking for possible answers.
*Updated post about my trip to Johns Hopkins for SIBO breath testing and a visit with a well informed GI specialist, Dr. Gerard Mullin.
**Updated FODMAP post with a detailed GP FODMAP handout!