Intolerance a pain in the tum

FODMAP. When you discover that it stands for Fermentable Oligosaccharides Disaccharides and Polyols, quite frankly it's a relief that they gave it an acronym - as strange as it is.

The FODMAPs themselves are also strange little beasties, capable of wreaking all manner of havoc inside the gut and bowel of those among us who cannot absorb them.

They are fermentable carbohydrates and they are found in a range of foods, many of them healthy.

Asparagus, onions, garlic, legumes/pulses, beetroot, Savoy cabbage, artificial sweeteners, sweet corn, apples, pears, mango, watermelon, nectarines, cow's milk, yoghurt, ice-cream, cashews, pistachios, wheat bread and pasta are all high FODMAP foods.

Sunshine Coast Dietetics director Sally-Anne Livock said that for the 30% of people who suffer from an irritable bowel, FODMAPs can cause pain and discomfort.

"You usually get a bloated, windy tummy, or sometimes feel like you're six months' pregnant by mid-afternoon," Ms Livock said.

"You also have altered bowel movements.

"The nerves lining the bowel wall are very sensitive to increased pressure. Foods high in FODMAPS cause excess wind, which then results in built-up pressure on the bowel walls.

"For those who have a sensitive bowel, this added pressure causes irritation and discomfort known as irritable bowel, and it's quite a common condition."

She said stress could often cause and exacerbate an irritable bowel.

"The sensitivity of the bowel-wall nerves relates to your ability to handle stressful situations.

"There is a huge nerve called the vagal nerve that runs from the brain to the gut, so it's a receptor of what's going on in the brain.

"And there have been studies that have found cells similar to those found in the brain in the gut."

If you are experiencing stomach bloat and suspect a FODMAP sensitivity, Ms Livock said it was a bad idea to self-diagnose and cut out all high FODMAP foods as a knee-jerk.

"You have to make sure you get the correct diagnosis because this can mask coeliac disease or iron deficiency or IBS.

"You need to see a dietician to conduct a trial whereby you take all of the FODMAPs out. If after four to six weeks the symptoms have been resolved, we would systematically introduce one group at a time to determine which (of the five) groups people are intolerant to.

"And intolerance is dose related, so they could tolerate small amounts occasionally or they might be super sensitive.

"I see huge number of people with it.

"I had a woman the other day who had suffered with these symptoms for 30 years.

"Now she says she feels like a new person.

"If you hit the nail on the head, it can be huge."

Ms Livock said the condition most commonly affected women, starting as young as late teens.

"The most important thing is to get the management right and make sure it is the correct diagnosis. One-in- three people with coeliac disease are missed," she said.


Monash University low FODMAP diet, iPhone app:

Dr Sue Shepherd's website:

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