FODMAPs (fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols) are hard-to-digest sugars which pass through the small intestine without being properly broken down. When FODMAPs pass into the colon, they ferment and create gas. While in the colon, they pull water into the gut. This water and gas builds up in the gut and may cause gas, bloating, pain, cramping, and diarrhea/constipation.
The FODMAP diet is a highly complex diet that cuts natural, hard-to-digest carbohydrates found in hundreds of foods. FODMAPs include common foods such as garlic, onions, wheat, and milk.
The Low FODMAP Diet is Complicated. Get a Cheat Sheet!
Here's a FODMAP breakdown:
Fructose: a natural fruit sugar found in many fruits, honey, high-fructose corn syrup and agave can be a problem either due to the lack of an enzyme in the body or the ratio of glucose to fructose in a fruit. Fruits with a high glucose: fructose ratio are generally well tolerated, such as blueberries, strawberries, cantaloupe, honeydew and ripe bananas, but those with a high fructose: glucose ratio such as apples, watermelon and mangoes may not be.
Lactose: a carbohydrate found in dairy products can be a problem due to a partial or complete lack of the enzyme lactase which digests lactose. Foods such as cow’s milk, yogurt and ice cream are lactose containing foods.
Fructans: are carbohydrates that are completely malabsorbed because the intestine lacks an enzyme to break their fructose bond. Wheat accounts for most of people’s fructan intake, which can be found in breads, cereals, and pasta, but they can also be present in onions, garlic and other vegetables. This is not to be confused with Celiac Disease, or a gluten sensitivity which is related to the wheat protein, gluten.
Galactans: are carbohydrates that are also malabsorbed because the intestine does not have the enzyme to break them down. Beans, peas, and lentils are primary examples.
Polyols: also known as sugar alcohols, are found naturally in some fruits and vegetables and also added to sugar-free gum, mints, and cough drops. The names of some of these artificial sweeteners end in ol- like sorbitol, xylitol, mannitol, and malitol. Apples, pears, stone-fruits, mushrooms, and cauliflower would also be high sources of polyols.
How do FODMAPs trigger symptoms?
1. When FODMAPs pass into the colon, they ferment and create gas.
2. While in the colon, FODMAPs pull water into the intestinal tract.
3. This water and gas builds up in your gut, causing bloating, cramping, pain and diarrhea/ constipation.
A low FODMAP diet can help.
These painful symptoms are preventable in up to 70% of people with IBS.* For patients with IBD (Crohn’s disease and ulcerative colitis), the Low FODMAP diet can be a beneficial addition to your medical treatment and has been shown to help improve quality of life.**
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* Source: P. Gibson, “The evidence base for efficacy of the low FODMAP diet in irritable bowel syndrome”
** Source: World Journal of Gastroenterology. May, 2017.