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Olwen Anderson's Blog

Getting off the FODMAPS diet

Wednesday, June 10, 2015
It’s a familiar story. My client is relating his or her journey with their gut problems. One of the options they’ve tried is the FODMAPs diet and – hey presto – their bowel symptoms have been relieved. But the FODMAPS diet is quite restrictive, curtailing intake of many foods that contain certain types of carbohydrate. And they don’t want to have to eat this way forever.

Although the FODMAPs diet is effective, it has two drawbacks.  
- Its restrictive nature makes eating out socially a nightmare; consume the wrong foods and the problems are back.  
- In my opinion (as a naturopath), just taking away the foods causing symptoms doesn’t address the underlying problem.

I’ve got an old-fashioned common sense viewpoint on gut disorders. Instead of having to permanently change what you eat, why not treat and rehabilitate the gut injury that’s caused the symptoms? (There are limits to this generalisation, of course: If you are a diagnosed coeliac, or have ulcerative colitis or crohns disease these are conditions which simply require life-long management.)

If you’re one of the people who found that the FODMAPS diet relieved your symptoms, but you have the perspective that the problem stems from an underlying gut problem, and you want to get off the FODMAPS diet, read on.

Here’s what’s been happening in your gut

FODMAP stands for fructooligosaccharides, oligosaccharides, disaccharides, monosaccharides, polyols; all types of carbohydrates. Because of their molecular structure they can be broken down in the small intestine very quickly. The excessive fermentation that results can lead to discomfort and bloating. Stop eating the FODMAP foods and the symptoms subside. 

Here’s how carbohydrate digestion should happen: It starts in your mouth, where enzymes within saliva start to break down the relatively weak bonds of carbohydrate molecules. Your pancreas adds some more enzymes not long after the food leaves your stomach, so that by the time it arrives at your small intestine the food components are almost ready to be absorbed. (Some forms of carbohydrates, like undigestible fibre, aren’t absorbed here but pass on towards the large intestine to be fermented there.)

Waiting on the surface of your small intestines are enzymes ready to complete the final breakdown. Now the smallest kind of carbohydrate molecule (a monosaccharide) is tiny enough to pass across the wall of your bowel into the bloodstream then head towards your liver for packaging and despatch towards hungry cells. But if your bowel wall is damaged, irritated or inflamed this might not happen.

Why your gut can’t cope with this any more

The transition from healthy gut to carbohydrate-intolerant can be gradual or sudden, but the sensitive bowel wall can easily be damaged.

Your small intestines look rather like a shag-pile carpet up close; sensitive cells that are replaced every few days are protected by a layer of mucous, on which enzymes and microflora (bacteria) reside. Here are some events which can contribute to a damaged bowel wall:

- Under relentless psychological stress that protective mucous layer thins, laying bare those sensitive cells that do the absorbing. Because the mucous layer has gone, the good bacteria and enzymes aren’t there much either.

- A gastrointestinal infection or parasite infection has irritated and inflamed your bowel wall.

- A course of antibiotics has upset your usual bowel flora.

Because everyone is unique, the process for rehabilitating your gut is unique too. It isn’t instant, and treatment is shaped around what caused your gut injury in the first place as well as rebuilding your bowel wall. But there’s a wide range of nutrients, herbs and homoeopathic remedies ready to help. Ready to look at getting off the FODMAPs diet? Give me a call! (0427 558 870)

If you enjoyed this article, you might also enjoy 'Healthy Biofilm Healthy You' here

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Olwen Anderson @olwenanderson


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