Irritable bowel syndrome affects approximately 15% of the population; It is one of the most common gastroenterological problems, characterized by symptoms of abdominal pain, distension, bloating and change in intestinal flora without any pathology.
Diet generally plays a major role in exacerbating the symptoms. Consumption of refined carbohydrates, especially sugar, is associated with the formation of IBD. Consumption of foods containing FODMAPs encourages excessive bacterial growth in the intestine. FODMAPs (fermentable oligo-di-and mono-saccharides and polyols) are an important trigger of functional intestinal symptoms.
Studies have shown that the absorption of short-chain carbohydrates (FODMAP) from the small intestines is poor in healthy people. Restricting short-chain carbohydrates in the diet has shown successful results in the treatment of IBS.
Short-chain carbohydrates (FODMAP):
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Fructo oligosaccharides found in wheat, rye, onion and garlic.
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Galacto oligo saccharides found in legumes and some nuts
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Lactose found in milk and dairy products
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Fructose found in apples, pears, watermelon, mango and asparagus
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Sugar alcohols found in artificial sweeteners
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Sorbitol, which is found naturally in stone fruits and is also used as a sweetener in chewing gums
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Mannitol is found in mushrooms and cauliflower.
Low FODMAP diet is based on the principle of reducing fermentable oligosaccharides, disaccharides, monosaccharides and polyols in the diet. Common properties of fructose, lactose, fructo and galacto oligosaccharides and polyols (sorbitol, mannitol, xylitol and maltitol) are as follows:
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They are slowly absorbed in the small intestine.
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They are small and osmotically active molecules. Especially synthetic forms (lactulose, etc.) affect intestinal motility.
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They are rapidly fermented by bacteria. Oligosaccharides and monosaccharides are fermented faster than polysaccharides such as water-soluble dietary fiber.
Studies have shown that a high-FODMAP diet is beneficial for healthy individuals. It has been observed that it causes gas complaints even from the second day, and in patients with irritable bowel syndrome, it significantly worsens the dominant gastro intestinal complaint (reflux, diarrhea, constipation, etc.) and causes lethargy (weakness, sleepiness). A significant decrease in complaints was observed in patients with irritable bowel syndrome who followed a low-FODMAP diet.
IS THE FODMAP DIET PERFECT?
It is true that the diet reduces gastro-intestinal system complaints, but when a low-FODMAP diet is consumed, the symptoms decrease. It was observed that the number of bifidobacteria in stool samples decreased at the end of the week. When bifido bacteria decrease, it is inevitable that the number of harmful bacteria in the intestine will increase, and bifido bacteria are protective against colon cancer.
For this reason, the FODMAP diet is not a diet that should be followed throughout life. It is beneficial but in the current situation it causes gas, constipation, diarrhea etc. It involves the process of eliminating the nutrients that cause complaints from the diet for a period of time (a few weeks) long enough for the gastro-intestinal system to recover and heal itself and for the number of harmful bacteria to decrease, and then adding them back into the diet in a controlled manner by detecting food intolerances, if any, and testing what amount can be tolerated.
If the person will have difficulty in following this diet, foods that cause gastro-intestinal system complaints can also be detected with a food intolerance test. According to the intolerance test results, eliminating foods for a while and adding them back into the diet will also be effective in relieving and eliminating the symptoms.
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