Question

Ryan is a 42-year-old male who has been experiencing bloating and either diarrhea or constipation within a few hours of eating at least once a week for the past two years. Certain foods seem to trigger his symptoms more than others, with dairy being the biggest trigger. Ryan has lost weight because he’s afraid to eat and incur these uncomfortable symptoms. At his wife’s urging, Ryan finally went to see his doctor and has been diagnosed with irritable bowel syndrome (IBS) and lactose intolerance.

Question 2: Ryan’s doctor has suggested that he try a low-FODMAP diet to alleviate his IBS symptoms. Explain what FODMAP are, some food sources of FODMAP and how a diet low in them may help Ryan. Support your answer with data, facts, key terminology, specific examples and other information drawn from the textbook and at least one other supplemental source.

Answer 1

1. FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, which are short-chain carbohydrates and sugar alcohols that are poorly absorbed by the body, resulting in abdominal pain and bloating. FODMAPs occur in some foods naturally or as additives.

2.

The main dietary sources of the four groups of FODMAPs include:

• Oligosaccharides: Wheat, rye, legumes and various fruits and vegetables, such as garlic and onions.
• Disaccharides: Milk, yogurt and soft cheese. Lactose is the main carb.
• Monosaccharides: Various fruit including figs and mangoes, and sweeteners such as honey and agave nectar. Fructose is the main carb.
• Polyols: Certain fruits and vegetables including blackberries and lychee, as well as some low-calorie sweeteners like those in sugar-free gum.

3. The increased fluid and gas in the bowel leads to bloating and changes in the speed with which food is digested. This results in gas, pain, and diarrhea. Eating less of these types of carbohydrates should decrease these symptoms. So far, studies have shown that a low FODMAP diet improves IBS symptoms.

According to a 2014 study in Gastroenterology, a reduction in dietary FODMAPs, which restricts certain short-chain sugars and fibers, improves symptoms in IBS patients, including both constipation and diarrhea predominant subtypes.