What are FODMAPS and How Do They Affect Your Health?

If you’ve ever struggled with bloating, digestive discomfort, or Irritable Bowel Syndrome (IBS), you’ve likely heard of FODMAPs. These short-chain carbohydrates and sugar alcohols are found naturally in a variety of foods, from fruits and vegetables to dairy and grains.

While they are completely natural, for some people – particularly those with IBS or Small Intestinal Bacterial Overgrowth (SIBO) – FODMAPs can trigger uncomfortable digestive symptoms. Understanding how FODMAPs interact with your gut and whether they may be contributing to your symptoms is key to improving your digestive health.

In this article, we’ll break down what FODMAPs are, explore their role in gut health, and discuss how a low FODMAP diet can be used as a tool to manage your symptoms while addressing any underlying causes. It’s important to note that FODMAPs are found not only in many fruits and vegetables, but also as food additives in items like cereals, honey, agave, candies, baked goods, and dairy products.

FODMAPs are types of carbohydrates found in many common foods. The acronym FODMAP stands for:

• Fermentable
• Oligosaccharides (e.g., fructans and galacto-oligosaccharides)
• Disaccharides (e.g., lactose)
• Monosaccharides (e.g., excess fructose)
• And
• Polyols (e.g., sorbitol, mannitol, maltitol, xylitol, and isomalt)

Some foods are higher in certain compounds called FODMAPs. For many people, especially those with irritable bowel syndrome (IBS), these FODMAP-rich foods can trigger unpleasant symptoms. They may also impact people with small intestinal bacterial overgrowth (SIBO) and potentially contribute to symptoms in those with autoimmune conditions like rheumatoid arthritis, multiple sclerosis, or eczema.

You see, as FODMAP molecules move slowly through the digestive tract, they’re poorly absorbed in the small intestine and draw in water. As they continue to the large intestine, the gut bacteria feed on these FODMAPs, causing them to produce excess gas through fermentation. This extra gas and water stretches and expands the intestinal walls. For people with sensitive digestive systems, like those with IBS, this stretching can lead to additional pain and discomfort. It may also affect how quickly the bowels move.

IBS often brings a range of unpleasant symptoms, including abdominal bloating and distension, excess wind (flatulence), abdominal pain, nausea, and changes in bowel habits like diarrhea, constipation, or a combination.

However, be aware that these FODMAP foods may not be the only trigger for your IBS symptoms. Even if removing these foods provides some relief, you may still experience ongoing issues. That’s because other foods or chemicals can also be culprits.

While avoiding high-FODMAP foods can certainly help manage your IBS symptoms, this approach is more of a temporary bandage. To truly regain optimal digestive health, it’s critical to work with a functional medicine practitioner to identify and address the underlying cause.

Your diet should be just one part of a well-rounded treatment plan. Removing problem foods is an important but short-term step in your recovery process. The real key is getting to the root of your digestive troubles with professional guidance.

It’s unclear whether IBS directly causes changes to the gut barrier and intestinal permeability, or if the irritation from FODMAP foods is the culprit. Some studies have found increased permeability in the small and large intestines of people with IBS-D, but other studies haven’t detected significant differences.

The immune system in the gut lining may compromise the barrier function and alter nerve signaling in the enteric nervous system. This “leaky gut” can further activate the immune system and cause systemic inflammation, as evidenced by elevated levels of lipopolysaccharides (LPS) in stool tests.

Furthermore, up to 70% of IBS patients also develop small intestinal bacterial overgrowth (SIBO). Interestingly, treatments for SIBO often involve dietary changes similar to the low-FODMAP diet. However, it’s important to always confirm SIBO through breath testing before starting any treatment protocols.

• Fructose is a sugar found in most fruits and vegetables like apples, mangoes, pears, and watermelon.
• Lactose is a sugar found in dairy foods like milk, soft cheeses, and yogurts.
• Fructans are very similar to fructose and are found in many vegetables (such as onions, garlic, asparagus, broccoli, cabbage), grains (whole-wheat bread, rye bread, wheat pasta), and cereals.
• Galactans are found primarily in legumes, such as beans, lentils, chickpeas, and soybeans.
• Polyols are sugar alcohols like xylitol, sorbitol, maltitol, and mannitol. You’ll find them mainly in artificial sweeteners and chewing gum.

There are many misconceptions about the low FODMAP diet, leading to confusion about its purpose and effectiveness. Let’s debunk five common myths:

1. The low FODMAP diet is a lifelong commitment – False. It’s a short-term approach, typically lasting 2-6 weeks, followed by a structured reintroduction phase to identify personal trigger foods. It’s not meant to be a permanent dietary change.
2. The low FODMAP diet is for weight loss – False. The FODMAP diet aims to manage IBS symptoms, not promote weight loss. It focuses on substituting high-FODMAP foods, not restricting calories.
3. The low FODMAP diet cures IBS – False. While the diet can significantly reduce symptoms, it does not cure IBS. Managing IBS involves multiple factors like stress management, lifestyle changes, and other dietary considerations.
4. The low FODMAP diet is gluten-free – Not necessarily. Gluten is a protein, while FODMAPs are carbohydrates. Some gluten-containing foods are high in FODMAPs, but others are not. Likewise, not all gluten-free products are low in FODMAPs.
5. The low FODMAP diet benefits gut health – Partially true, but with limitations. Reducing FODMAP foods can relieve symptoms, but long-term restriction can decrease microbiome diversity and fiber intake. That’s why the diet is meant to be temporary, with a focus on reintroducing as many well-tolerated foods as possible.

Foods containing FODMAPs are generally healthy, nutritious, and high in fiber. In fact, healthcare providers often recommend these foods as part of a balanced diet, as they can provide essential nutrients and support a diverse gut microbiome. The microbiome thrives on the variety of vitamins, minerals, amino acids, polyphenols, antioxidants, and dietary fiber found in colorful, plant-based foods.

In 2005, researchers developed the low FODMAP diet as a tool for managing irritable bowel syndrome (IBS). However, it’s important to note that proper digestive function plays a crucial role in how the body processes FODMAPs.

As food travels through the digestive tract, various mechanisms must work properly. If any of these processes are compromised, it can lead to symptoms of FODMAP intolerance. By working with a functional medicine practitioner, you can assess and improve your gut function, which may allow you to better tolerate FODMAP-containing foods over time.

Avoiding FODMAP foods for a period of time (e.g. 3 months) can improve symptoms of bloating, gas, diarrhea, or constipation. Eliminating these foods allows the gut to:

• Reduce overgrown bacteria
• Reduce inflammation
• Calm the immune system
• Allow beneficial bacteria to grow

Once your gut has healed, you can likely reintroduce FODMAPs, but it’s important to do so gradually and systematically:

• The low FODMAP diet is typically a temporary intervention, not a long-term diet
• After the initial elimination phase (usually 2-6 weeks), begin reintroducing high FODMAP foods one at a time
• Reintroduction helps identify which specific foods trigger your symptoms and which ones you can tolerate
• The reintroduction phase can take about eight weeks, during which you test each category individually
• Once you’ve identified your triggers, you can create a personalized, sustainable diet plan that includes tolerated FODMAPs
• In the long term, it’s beneficial to include as many foods as possible to support a diverse gut microbiome
• Even if your gut has healed, you may still have some sensitivities, so pay attention to your body’s responses as you reintroduce foods

At BionwoRx, we’re here to help you navigate this journey with expert guidance, offering tailored testing, dietary strategies, and practical support so you can restore your gut health and feel yourself again.