A low FODMAP diet may help patients suffering from IBS

Irritable bowel syndrome (IBS), a chronic medical condition affecting about 9 per cent of the population in Singapore, is typically associated with gastrointestinal symptoms such as flatulence, cramping or a bloated stomach.

Such gastric symptoms can be caused by a variety of factors such as abnormal movement of the gastrointestinal tract, impaired food absorption, intestinal bacteria and psychological factors such as anxiety. In most cases, the cause is benign and the gastric discomfort can be treated with dietary and lifestyle management.

What causes abdominal bloating?

“Abdominal bloating is a common complaint and may be due to numerous medical conditions involving both the gastrointestinal tract as well as other organs,” says Dr Wang Yu Tien, Senior Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH), a member of the SingHealth​ group.

When the cause of bloated stomach and other IBS symptoms is the fermentation of poorly absorbed foods in the large intestine, a diet low in highly fermentable foods has been found to help. The low FODMAP diet, developed at Monash University in Melbourne, Australia, is a diet which limits such highly fermentable carbohydrates. The low FODMAP diet may be recommended for patients suffering from IBS.

What are FODMAPs?

FODMAPs are short-chain carbohydrates. The term FODMAP stands for fermentable oligosaccharides, disaccharides and monosaccharides, and polyols.

FODMAPs Food Examples
Fructose Honey, high fructose corn syrup (HFCS), fruits such as apples, mango, pear, watermelon
Lactose Dairy products such as ice cream, milk, milk powder, soft cheeses, yogurt, custard
Fructans Vegetables such as artichoke, garlic, onion; grains such as barley, rye, wheat: prebiotics added into foods such as inulin, FOS (fructo-oligosaccharides)
Galatans Beans, legumes, lentils, soy
Polyols Sorbitol, mannitol, xylitol, maltitol (very often found in 'sugar-free', 'low-carb' and 'diet' products); and stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums

“FODMAP foods are poorly absorbed in the small intestine and when they travel to the large intestine, bacteria ferments them, which may give rise to wind, bloating and cramps,” says Ms Cherry Li, Senior Dietitian, Department of Dietetics, also from SGH.

“These poorly absorbed foods also pull water into the intestines, which can cause watery stools and diarrhoea,” she adds.

Following the low FODMAP diet

The dietitian will carry out a dietary and nutritional evaluation based on your gastric symptoms before recommending the low FODMAP diet. Typically, you will restrict FODMAP-rich foods for three weeks. The dietitian will recommend alternative foods to make sure your diet remains nutritionally balanced.

If your gastric symptoms respond to the new diet, your dietitian will reintroduce the restricted FODMAP foods one by one, to assess your level of tolerance to the food.

“In this way the dietitian will create an individualised eating plan for you, limiting trigger foods and incorporating the FODMAP diet approach, and ensure your diet is nutritionally balanced for the long term,” says Ms Li.

General dietary tips for patients suffering from bloated stomach and other IBS symptoms

  • Avoid oily and spicy foods
  • Avoid alcohol, caffeine and carbonated beverages
  • Eat frequent, small meals and avoid large meals
  • Chew food well and eat slowly

Ref: R14​

Check out our other articles on IBS (Irritable Bowel Syndrome):

IBS in Singapore: More Common Than You Think

IBS: Common Symptoms and Treatments

Stomach Pain: Is It IBS or a More Serious Condition?

Diet and Lifestyle Tips for IBS

Can Anxiety or Depression Trigger IBS?