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IBS: When FODMAP is Not the Solution
Other Conditions to Consider
- Some people may be intolerant to beta-casein type A2, which is a variant of a type of protein found in cow’s milk. In this case, symptoms usually occur quickly following the ingestion of dairy products, even lactose-free products, and can include various symptoms (diarrhea, constipation, gas, bloating, severe abdominal cramps). For more information, read this article.
- Some people may have a histamine intolerance, which can develop when the body produces more histamine than it can break down. If histamine levels in the body are high for some reason, the consumption of histamine-rich foods can trigger various symptoms that can differ from person to person. Just like people who are intolerant to FODMAPs, those who have a histamine intolerance may have digestive symptoms. However, unlike FODMAP intolerance, a histamine intolerance is usually also accompanied by non-digestive symptoms. These may include a tightness sensation in the throat or chest, heart palpitations, migraines, headaches, vertigo, dizziness, joint or muscle pain, hot flashes, itching, hives, eczema, fatigue, depression, and nasal congestion. Symptoms can differ greatly from a person to another. Generally, symptoms can occur immediately after ingestion of a trigger food, or later (two to four hours later). Sometimes symptoms can vary depending on the season. For more information, read this article.
- Small Intestinal Bacterial Overgrowth (SIBO) is an increase in the number of bacteria in the small intestine that are normally found in large numbers in the colon, resulting in excessive fermentation, inflammation and malabsorption. The digestive symptoms of SIBO closely resemble those of IBS, making diagnostic delineation difficult. For more information, read this article.
Conclusion
In conclusion, a Registered Dietitian who specializes in gut health can perform a nutritional assessment to help identify food triggers and provide personalized nutrition recommendations.
Sources
1) Hookway et coll. (2015). Irritable bowel syndrome in adults in primary care: Summary of updated NICE guidance. BMJ; 350:h701.
2) Singh et coll. (2022) The Role of Food in the Treatment of Bowel Disorders: Focus on Irritable Bowel Syndrome and Functional Constipation. Am J Gastroenterol;117:947–957.
3) Kim et coll. (2020) Sucrase-Isomaltase Deficiency as a Potential Masquerader in Irritable Bowel Syndrome. Dig Dis Sci; 65(2):534-540.
4) Daileda et coll (2016) Disaccharidase Activity in Children Undergoing Esophagogastroduodenoscopy: A Systematic Review. World Journal of Gastrointestinal Pharmacology and Therapeutics; 7(2): 283–93.
5) https://www.sucroseintolerance.com/2017/02/24/4-4-4-challenge-simple-home-test-sucrose-intolerance/
6) https://www.sucraid.com
7) Camilleri (2015) Bile Acid Diarrhea: Prevalence, Pathogenesis, and Therapy. Gut Liver; 9(3): 332–339.
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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