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Low-FODMAP Diet and its Relationship with IBD Symptoms

Posted by Brad Dennis, Ph.D. on

Low-FODMAP Diet and its Relationship with IBD Symptoms

Inflammation occurs when our body’s white blood cells release chemicals to protect us against foreign substances, usually around the area of an injury or infection. This tends to result in the redness, warmth, and/or swollenness in the area. Just like our skin and joints, our digestive tract which stretches from the mouth to the large intestines are susceptible to inflammation.

 Inflammatory bowel diseases (IBD’s) are disorders that cause inflammation of the digestive tract, which mainly include Crohn’s disease and ulcerative colitis. This is not to be confused with Irritable bowel syndrome (IBS), though sometimes patients can suffer similar symptoms. A clearer definition between the two can be found here. Studies have shown links between the intake of a low FODMAP diet with patients suffering from IBD’s. Though there is no diet to cure IBD, a low-FODMAP diet has been known to significantly reduce the symptoms. In the past, low-FODMAP diets have been known to substantially alleviate symptoms and have received a lot of interest in it’s application to IBD.

                Simply put, FODMAP’s are short chain carbohydrates found in everyday food that are poorly absorbed by the intestines. Most people would be surprised by the list of high-FODMAP food that is present in our everyday diet. FODMAP is an acronym for:

  • Fermentable (gas-producing)
  • Oligo-sacccharides (fructans)
  • Di-saccharides (lactose)
  • Mono-saccharides (excess fructose)
  • And
  • Polyols (sugar alcohols).

These carbohydrates bypass the small intestines instead of being broken down and absorbed into the bloodstream. Then, they are fermented by bacteria in the colon and release gas. Those with sensitive guts will experience bloating, diarrhea, and/or substantial abdominal discomfort. Loose stools or diarrhea are also common symptoms patients face as they are osmotic in nature and pull water into the intestines.

Patients who follow the low-FODMAP diet restrict themselves from eating high-FODMAP food for 6-8 weeks and re-introduce small amounts of high-FODMAP food as their symptoms clear. A substantial list of anti-inflammatory foods can be referred to for anyone wishing to make a change in their diet, though consulting a certified dietician is highly recommended.

According to Gibson (2017), restrictions of a FODMAP diet have improved the symptoms of 56% of 72 patients suffering from IBD’s based on an observational study. They claimed that the overall abdominal pain, bloating and wind had improved, as well as diarrhea for all the patients.

Another study in the UK by Prince et. al showed a strong correlation between a low-FODMAP diet and patients suffering from IBD.  For six weeks, 88 patients (39 Chron’s disease, 38 ulcerative colitis, and 11 unclassified) were advised to undergo a low-FODMAP diet by a gastroenterology dietician. The results were quite encouraging, showing that there was a decrease in severity for most of the symptoms. There was also improvement in stool consistency and frequency between the patients. Much of the research can be accessed here.

Though there are strong evidences to suggest a low-FODMAP diet would work well for those suffering from IBD’s, there are areas of concerns for someone willing to go this route.

As it is, those suffering from IBD may already be undernourished. Restricting their diet even further could compromise their nutritional state, and therefore should always be advised and overlooked by a certified dietician. Complications such as weakened immune system may occur if the risked isn’t taken seriously.

Currently, the information on the effect of undergoing a low FODMAP diet on the inflammation of the intestines is vague, and more research is still needed on this matter. In a random cross-study of 8 patients suffering from Crohn’s disease, a 3-week exposure on the low-FODMAP diet of varying amounts had shown no effect of fecal calprotectin.

Having a raised calprotectin level in the body is associated with the inflammation of the intestines. Higher calprotectin levels indicate more inflammation in the intestines. However, the question of whether a 3-week low-FODMAP diet is as effective as a 6-week low-FODMAP diet must be taken into consideration. Furthermore, Danish studies have not shown consistent changes in inflammation within patients suffering from IBD.

Evidence from, mostly, observational studies have found low-FODMAPS diet to be efficient in relieving symptoms of IBD. However, high-quality evidence regarding this matter is hard to come by, as suggested by the previous paragraph. We can never rule out the possibility of a placebo effect taking place for as long as hard evidence hasn’t emerged. The risks associated when making such a dietary change has to be seriously considered and follow professional advice.

 Bio: Stewart is the content and marketing manager at TheGoodGut - a new project devoted to maintaining gut health. Being a passionate writer, he aims to raise the awareness of the importance of gut health to the overall well-being of any individual.




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