Sunday, September 25, 2011

Foods Affecting IBS - FODMAP

As you may already know, Irritable Bowel Syndrome (IBS) is one of the many coexisting conditions that I experience as part of Fibromyalgia.

My understanding of IBS has always been that when a person experiences seemingly random bouts of abdominal cramping, diarrhea, and/or constipation and other digestive maladies, and no medical reason can be found for these symptoms, the diagnosis is IBS, meaning that person's digestive tract is basically stamped as being "fussy" for whatever, unknown reason.  Treatment usually focuses on addresses whichever symptoms are most bothersome, though there is no cure for the condition.

Since Fibromyalgia seems to make our bodies very sensitive to the world in many ways, it seems logical that the coexisting conditions and symptoms that tend to come with the FMS package have a lot to do with sensitivities.  We are extremely sensitive to pain or stimuli that should not even evoke pain in normal people, such as touch.  Our bodies are sensitive to activities, as we are easily fatigued.  Certain sounds, sights, and smells can cause us pain and trigger migraines or flare-ups.  Many of us have allergies and various other sensitivities to temperature, airborne particles, and foods.

I have many allergies, including some that affect my nose (allergic rhinitis), some that affect my breathing (allergic asthma),  some that affect my skin (dermatitis, dermatographism, delayed pressure urticaria and various other hives triggering conditions), and some that affect my digestive tract (food allergies and oral allergy syndrome([OAS]).  My food-related sensitivities seem to have started only in the last few years.  Among them is a mild apple allergy that was confirmed after OAS symptoms began to get progressively worse after each apple I'd eat.  Since birch pollen allergy is associated with being sensitive to apples, I checked the OAS list associated with birch pollen again, recently, when I noticed that eating a handful of almonds seems to have given me some sudden digestive distress.  It turns out almonds are indeed included in some OAS lists for birch pollen, but I feared that drinking almond milk with my cereal most workdays for breakfast may have caused a new, legitimate food allergy.  I'm not thrilled about the possibility of having to avoid another food due to allergies, especially since nuts seem to touch a lot more food than apples do.  This is the part where I start to wonder if I'll keep adding new food allergies until I eventually can't eat anything without histamines flooding my system and making me miserable.

Well, during my recent research on OAS and foods that can cause problems for people, I came across an article that discussed new studies being done on IBS being linked to foods with a high FODMAPs.  I'd never heard of this term before, but learned that it has to do with fructose and the types of sugars contained within the foods.  These characteristics have been grouped to help determine which foods might trouble a sensitive digestive tract, especially as the quantities eaten from the wrong category (high FODMAP rating) get higher.  Apples seem to be at the top of "bad" list, even though lists vary according to the publishing source, because of their high level of fructose.  However, not all fruits are high in fructose, as bananas seem consistently on the "good" list.  I find this new categorization of foods to be interesting and worth observing.

Do a search on the term FODMAP to find the exact definition of the term and the criteria used to categorize foods as having high, low, or questionable levels of the troubling substances.  I'm no expert on this, but I do remember noting that foods with lots of fructose (vs. glucose) can be troubling in the gut because fructose must be digested in the large intestines, rather late in the digestive tract.  The reason that late digestion is troubling is that it allows food to ferment and cause gas and other digestive problems.  There's a lot more to it, of course, and talking to a dietitian  is recommended, since eliminating foods from a diet can cause inadvertent problems with nutritional deficiencies.

For now, I'm sort of continuing to eat most of what I have normally been eating - a generally healthy diet with allowances for some less-than-healthy foods and treats now and then.  However, I am being cautious about almonds and switching to rice milk and soy milk for a while, to see if that makes a difference.  When IBS symptoms appear, I also have the good and bad lists of foods on the low FODMAP diet printed and handy, just to see if I've been eating perhaps too much from the bad list and not enough on the good list.

There are many lists online.  Here are some pages that I liked because they explain things a bit and have printable images listing the foods in each category and they are logically grouped.

http://www.cassandraforsythe.com/blog/Low+FODMAP+diet+has+been+great+for+my+gut
http://cassandraforsythe.com/blog/Complete+FODMAP+List+For+a+Happy+Gut
http://dysbiosis.blogspot.com/2011/04/fodmap-diet.html

Here is the page I found that introduced me to the FODMAP concept and informed me about the IBS connection.

http://ibs.about.com/od/ibsfood/a/The-Fodmap-Diet-For-IBS.htm

I'm hopeful that this research can be helpful to IBS sufferers like myself and give them more power to help control or at least minimize their symptoms.   As always, if you have knowledge or experience relate to this topic, please comment below.