"Bloat" is a word I hear multiple times daily from my patients with Irritable Bowel Syndrome.
We've been searching for an IBS solution for years. Millions of Americans are estimated to have IBS — 15.3 million, according to the National Institutes of Health. In fact, IBS is the second leading cause of absence in school and the workplace, following the common cold.
We know that patients with IBS poorly absorb certain foods, and this malabsorption leads to digestive woes. But for a long time, we didn't know how to accurately identify and remove offending foods from the diets of IBS patients.
Then, in 2010, a scientific breakthrough allowed more precise dietary treatment of IBS. Dietitians call this breakthrough "FODMAP" and the treatment arising from it a "low FODMAP diet."
Put simply, FODMAP is an abbreviation comprised of the first letters of the various sugars and carbohydrates occurring naturally in foods. These sugars and carbohydrates are the culprits that cause bloat, pain, gas, diarrhea and constipation of IBS sufferers. A food can have a high FODMAP level, a low FODMAP level or no FODMAPs at all.
Limiting a patient's diet to foods with low FODMAP levels can reduce IBS symptoms up to 80 percent.
The first step is to remove potential trigger foods from a patient's diet for a period of 4-6 weeks to identify any food intolerances. Then, with the help of a registered dietitian, one problematic food at a time is slowly reintroduced to the diet to see if the patient can tolerate that food. Once that food has been dealt with, a second trigger food is reintroduced, and so on.
Some of my patients have been able to reintroduce and enjoy foods with high FODMAP levels. Others must follow a more restrictive FODMAP diet.
Sounds great, right?
It is! But, you should know that this is not an easy diet to follow faithfully. You have to plan your meals, shop carefully and read all food labels from top to bottom. Most of all, you have to be compliant for the entire 4-6 week period.
However, if you can hang in there for the initial period of the diet, you are going to feel better in the long run.
Some foods that must be avoided on a low FODMAP diet are surprising. An apple, for instance, is a high FODMAP food that will send most IBS patients to their GI doctor.
Some other foods with high FODMAP levels:
Sugar free gum? Get rid of it.
Milk with cereal; ice cream for dessert? Out.
Wheat bread or pasta? Bye, Bye.
Here are some foods with low FODMAPs: carrots, spinach, lettuce, tomato, sweet bell peppers and hard cheese like Parmesan.
Foods with no FODMAPs include eggs, chicken, turkey, fish, and lean beef.
I work closely with IBS patients to teach them how to plan and enjoy meals on their low FODMAP diet. Here is a family recipe I share with my IBS patients that anyone can enjoy!
Frittata in a cup - makes 12 servings
1 dozen eggs*
1 -16 oz. frozen steam- in –the- bag chopped spinach*
1 tsp pepper*
1 tsp paprika*
1/2 cup grated Parmesan cheese*
Preheat oven to 350°.
Spray muffin cups or wrappers with cooking spray.
Steam spinach in bag as directed on package.
In a large bowl, beat the eggs. Add the cooked spinach, pepper, and cheese to the beaten eggs.
Spoon batter into muffin pan no higher than ¾.
Bake 20- 25 minutes – Frittatas are done when a toothpick is inserted near the center and comes out clean.
Let cool in pan for 7-10 minutes.
Any leftover frittatas can be refrigerated up to 5 days and then frozen if not gobbled up immediately.
*NOTE: Low FODMAP foods
Emily Rubin, RD, LDN, has worked for Thomas Jefferson University Division of Gastroenterology and Hepatology since 2001; she is also the Main dietitian at Jefferson's Celiac Center, Fatty Liver Center, and Weight Management Center. In her spare time, Emily is a mother of 12-year-old twin boys who also share in her passion of cooking, baking and eating healthy-but-delicious foods.