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1.31.2023

My FODMAP Journey

I have always been a good eater. A member of the clean plate club. A proponent of eating anything and  everything and lots of it. I have never been a picky eater. However, I have always had an issue with slight bloating. It never was horrible, but if I ate a big bowl of cauliflower for lunch, a bowl of chili for dinner and two apples with peanut butter for dessert, I would probably have a slight stomach bulge, or what we would call a burrito baby, and would definitely have tight pants. Usually it was gone the next morning and I could go about my day. 

However, a couple of years ago, I noticed that it was becoming more frequent and more severe and it seemingly didn't really matter what I ate, if I ate or if I didn't eat, how much I ate etc. I was often so bloated that I looked I was five months pregnant (and felt that way too!) and was having severe pains in my upper stomach at times. I went to see a gastroenterologist and she gave me a blood test which came back all clear and then put me on a low FODMAP diet. What the heck is a FODMAP, you ask? FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. So now that we are clear... But wait, what? We are not clear? What is all that gibberish, you ask? 

Disclaimer: I am no doctor, nor chemist, nor biologist. But I took organic chemistry once a long time ago, so I will attempt to break it down. These are short-chain carbohydrates (sugars) that the small intestine absorbs poorly, and eating them can cause digestive issues (often due to them fermenting while in the intestine). All of the fancy names have to do with how many units make up the chain. For the purposes of matching the Monash list, let's refer to them as Oligos (which include fructans, not to be confused with fructose), Lactose (Di), Fructose (Mono) and...Polyols (which includes mannitol and sorbitol). Still a bit lost? 

You will be familiar with many of the main culprits: beans, wheat, cauliflower, lactose and garlic, along with many other fruits and vegetables. Some of the items are red, as in do not eat at all, and that is manageable. However, some are yellow, as in you can have 10 grams of it and be okay. However, you may not be able to have 10 grams of one yellow and 10 grams of another without having issues. Plus, who eats only 43 grams of corn? P.S. That is about 2 tablespoons. You can see the full detailed list here (as of 2022). 

From Ecosh

The first step of the diet is the elimination phase. For me, this was an eight week period where I eliminated all of the red and most of the yellow items on the list. To be honest, I did feel better during this phase, but it is a pain in the butt. You can't have garlic or onions or beans or wheat or lactose. I definitely did not eat out except for maybe once (Japanese was really the only thing I could eat, except soy was also not allowed - sashimi anyone?) and was "that guy" at any dinner with friends ("I'll just have a plain lettuce leaf with a whipped air dressing and a glass of water, thanks"). It did keep me from snacking (I ate A LOT of carrot sticks) because my main go to is fruit, which was probably the hardest part of this phase. I love fruit, especially apples, which are on the red list. 

The second part is the reintroduction phase. Do not think that this is all an all-you-can-eat fun party, because its not. This is another eight to ten week phase where you introduce one food from one category for three days straight, ramp up the quantity each day, see how it affects you and then go back to elimination for four days. Then on week two, you try a different category for three days, take four days off, try a new category for three days... you get the picture. The twist is that even if you think that the item does not bother you, you do not continue eating it. Basically except for the three days where you ate it, for the other seven weeks and four days, you are essentially still eliminating that category. You can read more on the Monash website

The reason you do it for so many weeks even though there are only four categories is that you may need to try several things in the same category. For example, garlic, onions, beans, bread and many common vegetables are in the oligosaccharide category. Its best to test out each one separately, as one of them may be the trigger, but you won't necessarily have an issue with all of them. And who wants to give up garlic if they don't have to!?

You also want to make sure you are trying things that are only in one category. For example, apples have both fructose and polyols, so you would not want to see if fructose is your issue by having an apple because if you did have an issue you would not know if it was the fructose or the polyol. You would be better off to have orange juice, a fig, or a mango to see if fructose was the issue (or rum apparently, although I would stick to something you consume often - you do you). For polyols you might want to try a yellow peach, cauliflower or a mushroom. This NHS video is also very helpful in explaining the reintroduction method. 

My nine weeks worth of tests were

Oligos (broken into five): black beans, garlic, onions, bread, artichoke

Lactose (Di): yogurt

Fructose (Mono): mango

Polyols (broken into two): avocado (sorbitol) and cauliflower (mannitol)

Of course all of this is done alongside journaling and really trying to be at one with your intestines, which can be fun but tedious at the same time, and trying to live life. Was that stomach rumble hunger, or should I have not eaten more than 27 grams of cauliflower today? Do I have a tummy ache from the bread, or was it the two bowls of oatmeal I ate this morning with butter and maple syrup? 

To wrap this up for now, I know you are wondering what the end result was. I would like to say that one thing really bugged me, I stopped eating it and I am happy and svelte and bloat free. However, that is not the case. I have learned that there are a few things, or high quantities of other things, that do seem to be worse, but there are still times when I do not eat those items and I have issues, so it is still a work in progress. Usually I find out by making a mistake (i.e. do not eat two large bowls of popcorn in one sitting, especially after eating three bean soup) but at least I am on the right path. I am not on full reduction, but something more like a maintenance phase for now. 

Also, like I said, I am not a health professional and I usually am not a proponent of supplements either but I started taking two probiotics that were recommended by a friend of my brothers and they seem to help a little: the first you take right before you eat, and the second you take at the end of the day after you are done eating. They are kind of expensive, and it took about a week before I noticed any effect, but they do seem to help reduce the tight pant syndrome! Sometimes that feeling of tight pants is not just physically demoralizing, but mental too and so in this case, I will try anything! 

Feel free to reach out personally with questions; I am happy to get into (TMI) more detail if needed! 

Have you ever had gastro issues? If so, what did you do to get rid of them? If not, what other issues have you had and how did you overcome them? 

6 comments:

  1. I have done several elimination diets for various health issues; my biggest culprit is garlic. If I eat it I feel sick and even get upper abdominal/chest pain. It took me a LONG time to figure this out, but now I avoid garlic almost entirely.
    I also am very sensitive to lactose and it happened immediately after giving birth to my daughter. I do okay with occasional cheese/yogurt/butter, but I use oat or lactose-free milk (if I make a cheesecake - my FAVOURITE dessert - I use lactose free cream cheese) and rarely eat ice cream.

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    1. Yeah, I am hesitant to give up garlic but I do think that it and onions are probably going to be not as prevalent in my life.... I immediately noticed issues with wheat and peaches, but am still kind of figuring out some of the others (popcorn and beans also seem to be an issue). I never was a big milk person, but I do like a yogurt from time to time, but luckily that has not seemed to affect me too much!

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  2. You and I should talk, Kyria. You saw in one of my recent posts that I also deal with GI issues and have been trying to figure it out for a couple of years. I have some bloating, but it's not my main symptom. It mainly started with chest pressure/discomfort and some upper stomach discomfort and lots of gurgling.
    I had an upper endoscopy last year with no results that would explain my symptoms. I did have an h.pylori infection years ago, but now repeatedly tested negative. I do believe though that my issues are caused by low stomach acid which my gastroenterologist completely dismisses as a possibility. I have been treated for acid reflux, although I don't believe I have too much acid. (Have you heard of the baking soda test? You take baking soda in water on an empty stomach and if you don't burb within 5 minutes, it's likely that you have low stomach acid that doesn't react with the baking soda). I've done the test repeatedly and NEVER burp... which probably means my food sits in my stomach and is not being properly - or very slowly - digested and therefore causes bloating/pressure. I don't know, I am not a medical expert, but this all makes so much sense to me and I've been experimenting with HCL (hydrochloric acid) supplements to get my stomach acid up. I've greatly reduced my symptoms since last summer. Your issues might be of a completely different nature, but I am intrigued to hear more. I have contemplated an elimination diet but not even my gastro suggested that as something to try (probably because it was easier to just try to get me to take PPIs). Sigh.

    Sorry for the novel. I have a lot of feelings about all this. Ha.

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  3. Ugh. I'm so sorry you're dealing with this. My husband has a lot of dietary restrictions because of celiac and a billion mild/moderate allergies. He also has some weird cross-reactivity allergies. So he can't eat a lot of anything that tastes good like garlic and onions and tomatoes. It's definitely a challenge, but nothing compared to FODMAP diets which sound so restrictive. Could you give us an idea of what you would eat on a daily basis before you started reintroducing food?

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  4. This is so interesting! It sort of reminds me of the whole 30 diet although that diet was so hard that I didn't do the true reintroduction phase because I was ready to get back to more normal eating patterns. Some of your off-limit foods are my favorites - like apples. Phil/Will/me share an apple every night while we watch Wheel of Fortune (aren't we fun? Ha!). I already felt pretty restricted with my gluten intolerance so I feel like it would be hard to add other things in. I can go without gluten, it hasn't been all that hard now that I've been doing it for over 10 years!

    I'll definitely need your help coming up with some meal ideas while you are here! We'll probably get take out one day and maybe get lunch on Monday but will otherwise eat at home! I was thinking we could have a cauliflower tikka masala dish tomorrow night but I think that is probably off limits so we'll come up with something else! Which is totally fine - we are not picky outside of my dietary restrictions!

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  5. This diet sounds HARD, lol. I would have a very hard time following it, but I guess if I had severe stomach issues, I'd want to sort it out. I have acid reflux from time to time (usually after eating pizza) but it happens so infrequently (I had an episode this month, but my last episode before this one was in September!) that I don't worry about it too much. I followed a GERD diet for a few weeks when I was having really bad stomach pains and I hadn't realized how much I was bloated (a bit harder to decipher when you don't have a flat stomach to begin with, ha!) until I took myself off citrus foods/tomato-based foods/soda/chocolate/etc. I realized it because I was going to a concert while I was on my diet and before I started it, the shirt I got for the concert was really, really tight but when I tried it on the day of the concert (after being on the diet for a few weeks), it fit perfectly. It's a sign that I probably should follow a GERD diet more regularly, but I don't.

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