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The low FODMAP diet and Coeliac Disease

What is Low FODMAP?

Stomach crampThe low FODMAP diet aims to help manage digestive symptoms such as bloating, abdominal pain, changes in bowel habit, gas and nausea, which may potentially be caused by intolerance to foods high in FODMAPs. It’s an evidence-based approach developed by Dr Sue Shepherd, whose research has shown that limiting intake of FODMAPs can ease symptoms for 75% of irritable bowel syndrome (IBS) sufferers.

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are types of carbohydrate which are commonly found in many foods, but may be poorly tolerated by some people.

The diet is not designed to be permanent, but is instead a 2-stage process aimed at determining an individual’s tolerance to different sources and amounts of foods containing high levels of FODMAPs. The first stage involves a strict restriction of high FODMAP foods for around 6-8 weeks to see if symptoms improve; followed by the second phase where foods are gradually reintroduced and symptoms can be assessed to figure out problematic foods. This should be done under the supervision of a specialist dietitian who can help guide individuals on how to maintain a balanced diet and manage symptoms.

Examples of foods high in FODMAPs include:              

  • Dairy products such as milk or yoghurt (due to lactose)                                                                                                                                       Yogurt Fruit
  • Fruits high in excess fructose such as apples, pears, or large servings of dried fruit or juice
  • Large amounts of wheat, barley or rye products, plus onions, garlic and legumes such as chickpeas and beans
  • Sweeteners such as sorbitol, mannitol and xylitol

 

Tolerance will differ between individuals and foods should not be excluded if not necessary.

Who is the diet aimed at?

The low FODMAP diet is primarily aimed at individuals with IBS, but may also offer relief for individuals who have been diagnosed with conditions such as coeliac disease or inflammatory bowel disease but are still suffering from IBS-like symptoms.

Why it might help those with coeliac disease

Prevalence of IBS symptoms in coeliac patients is estimated to be almost 40% according to one study (http://www.ncbi.nlm.nih.gov/pubmed/23246645). While digestive symptoms may be due to problems sticking to a gluten-free diet, for some people there may be ongoing symptoms despite successfully eliminating gluten, potentially suggesting simultaneous IBS.

If you are struggling to manage the symptoms of your coeliac disease despite strictly eliminating gluten, you may want to consult a dietitian. They can confirm no gluten is Gluten Free 2present in your diet, plus help you with following a low FODMAP diet in addition, if this is considered appropriate. They can also help you maintain a balanced diet so you’re still getting all the nutrients you need to stay healthy.

There are various food allergies and intolerances, with different foods affecting individuals in different ways. All deserve to be appropriately diagnosed and treated so they can continue to enjoy meals and maintain a healthy lifestyle, whilst avoiding certain foods where necessary. Here at Food Freedom we aim to raise awareness of food allergies, intolerances and coeliac disease, to encourage understanding and lessen discrimination. Please get in touch if there are any schools or food businesses you would like to see receive full training at info@food-freedom.co.uk

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