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Dietary Solutions for Irritable Bowel Syndrome (IBS)
The FODMAP approach
FODMAPs* are fermentable carbohydrates that may be partly responsible for the symptoms in people with IBS. These sugars can be poorly digested and accumulate in the small intestine. Digestive symptoms associated with FODMAP intolerance usually occur approximately two to eight hours after ingestion of foods high in FODMAPs. An intolerance to lactose, fructose, or polyols usually causes gas, bloating, and diarrhea, whereas an intolerance to fructans and GOS usually causes gas, bloating, and constipation. Stools can be lighter in color, cause a burning sensation, float in the toilet, or wake up people during the night. It should be noted that the total intestinal transit time between the moment a food is eaten and the moment when the residual waste is eliminated can take up to 72 hours. Therefore, even though FODMAP-sensitive symptoms usually occur two to eight hours after eating a meal, they can also last up to three days.
The FODMAP approach has been shown to be effective in reducing IBS-related digestive symptoms in approximately 75% of cases. For more information on the FODMAP diet, please read this article. It is also possible to take digestive enzyme supplements to promote the digestion of certain FODMAPs when the cause is a lack of enzymes. The lactase enzyme allows the digestion of lactose, the alpha-galactosidase (Beano) enzyme allows the digestion of GOS and the xylose isomerase enzyme allows the digestion of fructose. On the other hand, there are no enzyme supplements for the digestion of fructans and polyols. It is important to choose a supplement that contains the FODMAP-specific enzyme you are sensitive to, and to take the supplement at the right time.
In some cases, other dietary factors may be the cause of digestive symptoms. Here are a few possibilities.
1) Congenital Sucrase-Isomaltase Deficiency (CSID)
Congenital sucrase-isomaltase deficiency (CSID) is a genetic disorder that occurs when the body can not produce the sucrase-isomaltase enzymes required for the digestion of sucrose and maltose, which are two types of sugar. Sucrose is found in fruits, cane sugar (table sugar), maple syrup and in many foods that contain added sugars, while maltose is found in cereal products. Malabsorption of sucrose typically causes symptoms of gas, bloating, and diarrhea that occur approximately two to eight hours after ingestion of foods containing sucrose. Often, digestive symptoms can get worse if you follow a low FODMAP diet. The treatment for this condition is dietary restriction of sucrose and using an enzyme supplement named Sucraid. It should be noted that this enzyme supplement must be refrigerated.
*FODMAPs are fermentable carbohydrates that are partly responsible for causing symptoms in people with irritable bowel syndrome (IBS). For more info, read this article.
Author
Kathryn holds a Bachelor Degree in Nutrition as well as a Bachelor and a Master Degree in Kinesiology, all from Laval University. She is a Registered Dietitian and active member of the Ordre professionnel des Diététistes Nutritionnistes du Québec (ODNQ) and of the American Academy of Nutrition and Dietetics. She holds the Monash University's certification for the FODMAP diet and IBS, and has considerable clinical experience in that area. She is also an accomplished athlete, having ran track and cross-country at a national level. Kathryn specializes in sports nutrition, weight loss, diabetes, as well as heart and gastrointestinal health.
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