7 reasons the Low FODMAP Diet May Not be Working

The low FODMAP diet has been proven to help about 3 in 4 people relieve symptoms of abdominal pain, gas bloating and altered bowel movements that are characteristic of Irritable Bowel Syndrome (IBS). This is great! But, what happens if you are following the low FODMAP diet and it’s not working as well as it should, or even worse not working at all. This is frustrating. You just want to feel better. And so do we.

Here are 7 key points to consider before you throw in the towel.

1. Diagnosis

Lets start at the beginning, have you seen your doctor and ensured that your symptoms are IBS and not caused by something else? There are some other medical conditions that can mimic IBS type symptoms, but have different treatments. Have you self-diagnosed with Dr Google? Or have you given it a go because your friend got great results? If you haven’t been to the doctor, now is the time to do so. Effective treatment always starts with knowing what you are actually treating.

2. Goal posts

The second thing to consider is your level of response. A big part of having IBS is that the nerves in your gut are over sensitive and over communicate with the gut brain axis (you can read more about that here) and if you’ve been suffering for some time, it’s easy for symptoms to be over whelming. With the low FODMAP diet, we don’t expect gut variations day to day to completely go away. Its normal to have some fluctuations. Everyone gets a little bloated or has poop changes from time to time. This is actually a good thing and reflects a healthy and varied diet. The hard part of having IBS is differentiating between a “normal” change and a “not normal” change. A good bench mark is to consider your symptoms on a continuum rather that black and white. With low FODMAP, we want you about 70% better, about 70% of the time. If you have achieved this, that’s fantastic! If not, read on.

3. Where are you getting your information from?

It only takes a quick google to find a slew of resource son the low FODMAP diet. Unfortunately, a lot of these are contradictory, out of date or just plain wrong. When it comes to resources you use for a low FODMAP diet, there is a clear winner. Monash University developed the diet and continue to research the diet. It’s the Monash FODMAP diet that has been proven to work. Monash FODMAP have a smartphone app where you can access what foods are high FODMAP and what foods are low FODMAP and at what serve size. This is the gold standard and is updated regularly as new research comes to light. So if you haven’t yet, take the plunge and get the app. On the side, the money from the app goes back into IBS research, so you are doing a good thing by purchasing it.

Beyond Monash, a FODMAP trained dietitian is able to guide you and modify the diet based on your individual needs and situation. The research also tells us that people who do the diet with a FODMAP trained dietitian get better results, faster and save more money choosing foods in the supermarket due to confidence with choosing foods. A dietitian can assess your diet for any sneaky FODMAPs and consider other factors that may be playing a role, before formulating a plan to get you feeling better.

All Everyday Nutrition dietitians are Monash FODMAP trained. We love to help people resolve digestive issues and make peace with food so you can get back to the important things, like eating out with friends. We offer face to face and virtual consults and would be delighted to support you. You can book in here.

4. Stress

Stress is a significant trigger for IBS. It can be anything from big life events to chronic underlying stress of being busy. Stress levels increase cortisol and increase the sensitivity of all the nerves in your body, including those in your gut. If you already have a sensitive gut, then, well, you know the rest. If you think that stress may be playing a role in your symptoms, you might want to consider gut directed hypnotherapy as part of your IBS toolbox. There is actually some good evidence that this helps. You can read more about the research here. If gut directed hypnotherapy isn’t your thing, deep breathing, yoga, walking out side, listening to music, reading or connecting with friends may be some other ideas that help to manage stress levels. The key is to find what works for you.

5. Eating behaviours

It’s surprising how much impact how to eat can have on the gut. Our bodies like routine and they like to know what to expect. Eating moderate sized regular meals helps with digestion and regulate the Migrating Motor Complex (MMC). The MMC is like a street sweeper that comes through your gut about 90 minutes after eating, refreshing it and keeping it clean. If you eat too soon or leave too much time between meals, the MMC is knocked out of kilter.

Also consider meal size, speed of eating, talking while eating, chewing gum and fizzy drinks that can cause you to swallow excess air, exacerbating IBS type symptoms. Eating slowly, in a relaxed environment, chewing food thoroughly and avoiding chewing gum & fizzy drinks has been proven to reduce IBS symptoms.

6. Fibre

Fibre is essential for the gut microbiome, gut health and overall health and wellbeing. High fibre diets are associated with improved immunity, decreased inflammation and reduced risk of chronic disease like heart disease and diabetes. It’s also associated with improved bowel movements and digestive comfort. When it comes to IBS though, this can be a tricky balance. Not only amount, but type of fibre is important to managing IBS type symptoms. Are you getting enough? Are you getting too much? Have you got the balance or soluble vs insoluble vs fermentable vs prebiotic vs resistant starch right? If you’re not sure, this is something that our team of dietitians can help with. As a side note, if you do increase your fibre, make sure to also increase your water intake. Fibre needs water to work effectively.

7. Gut irritants

Smoking, alcohol, caffeine and spicy foods are all gut irritants and exacerbate IBS symptoms. Whole you won’t usually need to avoid these completely (except for smoking, don’t do that), doing a stock take of how much and how often to see if there is room for movement may be a good idea.

Final thoughts

The low FODMAP diet is a learning curve and tolerance does vary from person to person and also over a person’s life span. In addition, while the low FODMAP diet is the most well-known diet for IBS, it’s not the only option. Some people get better results with other dietary approaches. If you have ticked all of these boxes, and still not getting results. All is not lost. Our team of experienced dietitians are here to support you, guide you and be your cheerleader along the way.