The Low FODMAP Diet: A Complete Guide to Identifying Your IBS Food Triggers

Jessie Wong 00:00:00 Welcome to the IBS Nutrition Podcast, your go to source for navigating the complex diagnosis of irritable bowel syndrome. Here, we dive deep into IBS and discover the power of diet and lifestyle to find freedom from your IBS symptoms. I’m your host, Jesse Wong, Fodmap dietitian and a gut expert. For years, I suffered from debilitating gut symptoms that kept me out of work, feeling constant discomfort in my body and anxious around food. Today, I’m in control of my IBS. Able to eat the food I love again. Travel whenever I want and spend quality time with loved ones. It is my mission to help you do the same and transform the way you live with IBS. Let’s get started! Welcome to another episode of IBS Nutrition Podcast. Today we have a huge topic for you and that is a question we get all the time. What is the low Fodmap diet and how to identify your IBS food triggers? And today with me I have my amazing co-host Brooke Keenan who is our team IBS dietician, lead IBS dietician who has years of experience working with patients with IBS.

Jessie Wong 00:01:10 Hello, Brooke.

Brooke Keenan 00:01:12 Hi, Jesse. How are you?

Jessie Wong 00:01:14 I’m doing great. How are you doing today?

Brooke Keenan 00:01:17 I’m good too. Very good.

Jessie Wong 00:01:20 Yeah. We are both having a good day. And is it okay if I share a little bit of what we just did?

Brooke Keenan 00:01:26 Yes, of course.

Jessie Wong 00:01:28 We just recorded a podcast episode with one of our former clients. Her name is that it will be processed and uploaded soon. And Deb shared her story and about her going from nonstop IBS diarrhea to actually identifying her triggers and living a normal life. Now, now that she knows exactly what triggers her symptoms. And one of the things she shared was that she was taking a ton of supplements, went to many different types of providers, some of them not so evidence based, and was put on a lot of supplements and actually made her symptoms worse. So we actually just did a recording with Deb and she was so sweet. She had so many praises of how wonderful it was to work with Brooke, because she worked with Brooke together for over for about three months to identify her triggers.

Jessie Wong 00:02:18 So that’s what we did today, earlier today. And both of us are like in the clouds because we got so many places. And we also love our clients. And really thankful of her for sharing her story and giving hope to others who are currently struggling. Now today we are going to talk about what to eat for IBS, right? So what is the low Fodmap diet and how to identify your own food triggers? Here are the topics that we are going to talk about. Number one what is the low Fodmap diet? Why does it work. So that’s our first topic. Our second topic is what are the three steps of the low Fodmap protocol. So the low Fodmap diet is not a long term diet. It’s actually a short term elimination diet. So we like to call it the low Fodmap protocol in here so that, you know, you don’t have to stay on it long term. And number three, the topic number three that we’re going to talk about is some common mistakes that we see all the time.

Jessie Wong 00:03:12 So that you can avoid these mistakes and actually find your food trigger. All right, let’s get started with our first topic. What is the low Fodmap diet and why does it work. But do you want to go ahead and kick start.

Brooke Keenan 00:03:29 Sure. Yeah. So the low Fodmap diet is taking out fermentable carbohydrates. So FODMAPs are carbs that ferment in your gut and can cause gas and bloating, diarrhea, sometimes constipation. But the low Fodmap diet cuts those out and then is not a long term diet. It’s we cut them out temporarily and then add them back in one group at a time to see what you react to. And again, it is just a temporary phase until we can liberalize your diet as much as possible.

Jessie Wong 00:04:05 Right? exactly. can you share a little bit about the different characteristics of the FODMAPs?

Brooke Keenan 00:04:13 Yes. So some Fodmap well, they ferment in your gut, but some FODMAPs, like sorbitol can draw water into your gut, which sometimes can be helpful if you’re more constipated, but can be really problematic if you’re more prone to diarrhea.

Brooke Keenan 00:04:29 And a lot of times when they ferment in your colon, these FODMAPs can create a lot of gas and bloating. so research shows that when you find your low Fodmap triggers, you can improve your symptoms in IBS for about 70% of the people improve their symptoms following the low Fodmap diet.

Jessie Wong 00:04:49 I’m so glad you brought the research up because we just went to the biggest digestive disease conference last week. It’s called DWT. It’s called Digest Disease Week. What a mouthful. But it is the biggest GI conference in the world. Yes. And it happens once a year in North America and with researchers all over the world. And one of the things we keep hearing when it comes to food and IBS is the low Fodmap diet. We know the low Fodmap diet is gold standard. It works for most IBS patients. If you are doing it correctly. And I love how you said that they are all fermentable carbohydrates. However, some of them also have osmotic functions. Now what are the base group of default maps? Right there is fructose, lactose, sorbitol, mannitol.

Jessie Wong 00:05:40 These two are polyols and these four FODMAPs are osmotic. So what they do is they draw fluids into a small intestine, which is often when we hear our clients say, when I eat these things, I feel distended. There’s a lot of gushing and gurgling in the middle of a domino area. So these are the pumps are more likely responsible for that. And then there is also fruit ten and goes geos that are all rapidly fermentable. Actually, all fault maps are rapidly fermentable. Their short chain carbohydrates are highly fermentable. So when they get to our large intestine, they’re going to cause a lot of gas, bloating, and just a lot of gut symptoms that could be triggered by, you know, having more gas or more fluid in your gut, which is why temporarily removing FODMAPs have the effect of reducing IBS symptoms for IBS patients. And newer research that we know. after going to the conference and we just know by following the research, is also that removing FODMAPs for a short period of time actually reduces inflammation in the gut as well, because there are certain characteristics of the FODMAPs that actually triggers more irritation in the gut, causing people to have more severe symptoms.

Jessie Wong 00:07:01 But that is short term elimination. We’re not talking about something very long term. So if you have been recommended to low Fodmap diets, you know that it is a short term diet. And we know fault maps, fermentable carbohydrates, they are not well absorbed by our gut, which is why they move through the small intestine going into the large intestine where they are fermented. But the fermentation also means that they are feeding our gut microbes, right? So it’s not a bad thing. They are not bad for us, like some people have suggested. Some information you find on the internet may suggest that, hey, these are the reasons why you have IBS symptoms. Please cut them out for good. Now that is really not true at all. It is a very personalized approach. Identify what actually triggers your symptoms and remove those specific ones. Or only eats the amounts that you tolerate. Right. And that is basically what low Fodmap diet is in a nutshell, right? This is a very high level review of what the low Fodmap diet is and why it works.

Jessie Wong 00:08:06 Now let’s talk about what are the three steps of the low Fodmap protocol. And I think what we want to emphasize is actually how to challenge FODMAPs, how to reintroduce FODMAPs. Do you want to maybe give us a quick overview of how to remove higher Fodmap foods efficiently? So step one is eliminating FODMAPs.

Brooke Keenan 00:08:29 Yeah, yeah. Step one is eliminating the FODMAPs for usually no more than six weeks. Step two is reintroducing the FODMAPs step by step in a very systematic way. We break things down into groups and and then some little combo groups to see how people do. And then the third step is really living your life knowing which if any, FODMAPs trigger your symptoms. and it can take a bit of time. But we really don’t want anyone to be on the elimination phase for longer than six weeks. Certainly, if people have been not seeing a good response, it’s not a diet you want to keep doing. If you haven’t seen a response within 2 to 6 weeks, you’re not going to. Fodmap is not your jam.

Jessie Wong 00:09:18 Right? And sometimes we see that and we recommend other things appropriately. And then another thing we see is people making mistakes while they’re trialing the low Fodmap diet on their own, so that they’re not finding symptom relief. Now, when it comes to the challenge process in our program, we actually break it down into 12 groups and subgroups of FODMAPs so that we can really challenge every group, accurately over three days. And day one, we start with a very small dose of the food. Small serve. Day two we do a moderate serve of the food, and in day three we do a full serving of the food. To challenge I can use I will. I love using garlic as an example because all of our clients, after working together, they are able to tolerate garlic, which is something they’re so afraid of usually prior to working together. So garlic, you do one fourth clove of garlic on day one and then day two. they do half a clove of garlic. There is specific grams as well that’s related to how many grams you challenge.

Jessie Wong 00:10:16 And then day three is usually one whole clove of garlic to challenge your tolerance level. And so proudly we say all of our clients can actually tolerate garlic. after the three day challenge with no problem because it is a pretty small amount. However, in terms of Fodmap is equivalent to a half an onion on day three. So when people can tolerate the small amounts of garlic that, that we challenge, then we know when they go out to eat, they’re going to be fine. They don’t have to worry about people putting garlic or garlic powder in their food, and they’re afraid of running to the bathroom or having a significant amount of gas afterwards because they know they can tolerate it. And that also really helps somebody to stay calm and not be anxious when they’re eating certain things. Okay, so so that’s the three steps of the Low-fodmap protocol. And of course how to challenge. Right. So we do it systematically over three days and over 12 different groups of FODMAPs and found mapped subgroups of combination groups. And after the challenges we you will I mean, our clients will have a good idea of what they can tolerate and how much of it they can tolerate.

Jessie Wong 00:11:26 And the third step is really elaborating or liberalizing their diets according to their tolerance level, which is a lot easier, which helps them to live a normal life, really, instead of being on the very restrictive phase right now, let’s move on to the common mistakes that we see all the time, because sometimes it’s quite heartbreaking, right? So when people try out the low Fodmap diet on their own, they may not be doing it correctly. And when they don’t do it correctly, they may have a little bit of symptom relief, but not really long term symptom relief. And they end up cutting out more and more food, even on the allowed food in phase one of the low Fodmap diet, Would you want to maybe talk about what happens when people stay on the low Fodmap diet for too long and not trialing food as suggested?

Brooke Keenan 00:12:18 Yeah, I think one of the one of the things we see a lot is people that have been on low Fodmap for a long time, and those people too, are either haven’t completely cut out FODMAPs or they’ve cut out FODMAPs, and then they’ve continued to cut out more and more foods because they weren’t, you know, their doctor told them to cut out FODMAPs, but that didn’t really work.

Brooke Keenan 00:12:40 And so then they continue to cut out more and more foods. So it’s kind of a vicious cycle. And I mean, that’s where a dietitian really can come in that that knows what they’re doing to look at what you’re eating and figure out if maybe there were some FODMAPs that you hadn’t cut out because you didn’t know they were FODMAPs. You got an incomplete list from your doctor. all sorts of things. Or you were on a low Fodmap diet for so long, then you were terrified of adding foods, and then if you did add something in, you probably got gut symptoms, but it could have been from the anxiety of trialing the food. just so many places that you can kind of make an inadvertent misstep in following the diet. When you cut out a lot of FODMAPs, you can definitely cut out a lot of fiber as well. So cutting out the fiber in a low fat it, you need to work a little bit hard to get enough fiber in your diet on a low Fodmap diet too, right?

Jessie Wong 00:13:36 That’s a really good point.

Jessie Wong 00:13:37 Also, our second one of the biggest mistakes that we see people make all the time, right, is when they go low Fodmap, they really focus on the elimination part and not understand that while you are eliminating FODMAPs, you are removing a ton of fibers from your diet. But your gut also need fiber to have to perform its proper gut function, or even to support better gut health. Right? And one of the things we really recommend all of our clients do, and everybody who may be traveling the low Fodmap diet is make sure you are getting enough low Fodmap fiber to support proper gut function and proper gut health. we do have a free guide that can help you get started with the low Fodmap diet properly if you need help. The guide includes a grocery list, which we love to tell our clients to do is print out a grocery list shop according to the grocery list. So you’re looking at the list of food that you can actually eat, instead of a list of food that you cannot eat.

Jessie Wong 00:14:34 It comes with a meal plan and it comes with a swap list as well. So if you have ingredients that you need to swap from higher format foods to lower Fodmap food, that’s the list you will need. There’s also a vegan protein list too, to help anybody who might be a vegetarian to get enough protein while on the low Fodmap diet, so you can find a free Low-fodmap starter guide on our website. It is IBS dietician. dietitian. Com slash resources. And also we have a free IBS masterclass as well where we actually dive a little bit deeper on the low Fodmap diet in the masterclass. So if you are interested, register for that is completely free. And and we do see a lot of patients try out a low Fodmap diet on their own without success. A lot of the times their doctor may give them a one page handout. What you can eat, what you cannot eat and tell them to do the low Fodmap diet. Sometimes the physician will say go Google the low-fodmap diets and and hope you get the best results from it.

Jessie Wong 00:15:34 And it can be quite frustrating for us as a dietician is that patients are being recommended a restrictive diet without the proper guidance, and we see people getting into trouble when they try it on their own and not working out, but staying on it for too long. Okay, so key takeaway here is if you are not finding relief from the low Fodmap diet, you can either work with a dietitian who really understands what they’re doing to help you troubleshoot or abandoned diets. If it’s not working, it’s not worth your time and energy to keep going. Now, if you can’t abandon the low Fodmap diet, then I would really recommend for you to work with a dietitian to help you start reintroducing foods, because it is, again, not a long term diet. And if you need help, maybe just getting enough format fiber. Go grab our starter kit is again IBS dietitian. Com slash resources. We are going to put it in the show notes in the description as well, so you can find it. And and to help you maybe expand your diet a little bit.

Jessie Wong 00:16:35 All right. So this is what we talked this is what our episode is about, the low Fodmap diet. And we always end our episode with a client story to inspire you to know that there is a better way forward, even if you have IBS. And today, I want to share with you one of my first group coaching clients story. Her name is Karen. She is the sweetest person and she came to us for significant bloating constipation. She was taking laxative, but she was still not fully empty. And actually she had multiple e.R visits, emergency room visits because she had so much pain, she thought something was really, really wrong with her body. So she actually went to the ER multiple times for her IBS symptoms. And with her story she She also had a gastroenterologist. She also went to a natural path, and she sent different dietitians prior to working together. And a lot of their recommendations were they told her to get on the low Fodmap diet, cut out gluten, cut out dairy, and I think they told her to cut out the nightshades as well.

Jessie Wong 00:17:43 And it was really frustrating because she was cutting out more and more food and she was not seeing any improvement at all. And the only and and when she was cutting out so much food and not seeing improvement, it really made her more and more anxious about what to eat, what she can tolerate and won’t send her to E.R. or give her debilitating pain. So what we did together, right, was when she joins the program, we really identified what was causing of her symptoms. And of course, I told you already she had significant bloating and constipation. Now she had significant constipation. That was never really resolved with any of the providers that she had. And when you are very constipated, the low Fodmap diet, alone or not doing it properly is not going to help you because you are removing a lot more fibers from your diet when you go low Fodmap, and that can make constipation worse for people with ibs-c, which is again why, you know, the diet itself can help reduce some symptoms, but it’s not going to resolve your constipation.

Jessie Wong 00:18:51 So the first thing we did together was really help her create a routine that worked for her so that she had better evacuations every day. And that is key for anybody with Ibs-c. And I myself know that because that’s what I struggle with too. But anyways, we guided her through to create a daily routine that works for her. So we try all different things. drinking coffee, having a good breakfast, making sure she’s sleeping enough, making sure she’s managing her stress enough. So those are the lifestyle things that we work with. My clients work with us. And then when she finally have good bowel movements every day and really got her down to her symptom baseline, then we started reintroducing fault maps group by group. And after reintroducing the farm maps we identified, I think maybe 2 to 3 groups of fault maps were triggering her symptoms at larger quantities. I think lactose was one. And then also onion was one. I can’t remember if beans was one of her triggers as well, but with dairy or lactose and onions, she can tolerate them in smaller quantities.

Jessie Wong 00:20:02 That was totally fine. It was when it was a full serving that they started triggering some of the symptoms in her IBS. So after working together, she was able to start eating those foods again in smaller quantities. And that’s what we always encourage our clients to. If you can tolerate this Fodmap food in small amounts, go ahead and keep eating that smaller amounts, because what the formats will do is they go into your colon, they get fermented by the microbes that can break them down. So in return, what you are getting is really nourishing your gut microbes that can help you break down that group of labs and in the long run, hopefully their population will increase and you will be able to tolerate a higher dosage of that specific format group. And that’s always the goal when it comes to the low Fodmap diet is to expand your diet. Once we know your triggers. So expand your diet in a way that it won’t cause more symptoms in your guts, right? So she was one of my first ever group coaching clients and actually after working together well, two years after she did our program, she actually sent me a message one day.

Jessie Wong 00:21:10 She was like, Jesse, I’m so glad I did your program. And she went on a vacation for two weeks where she ate whatever, whenever and however she wanted. And she did had an episode of constipation after her vacation, but she knew exactly what to do to get back to her baseline and resolve the constipation quickly so she doesn’t have the debilitating pain that she had in the past where it’s sent her to the E.R.. So again, for anybody listening, you know, we are sharing client stories to encourage you and inspire you. There are proper ways to help you manage your IBS and more importantly, expand your diet. The key to better gut function is not by eliminating foods or no end. In fact, that’s going to make it worse because you are not feeding the gut microbes that are really there to help you break things down and help you stay healthy. Help your gut stay healthy. We really want to aim for a good variety of food in our diets, and that’s what research so far consistently suggests that, to improve gut health, you need to be eating 30 different types of plant based food every week.

Jessie Wong 00:22:22 Now, that’s the end goal for most of our clients, because when we’re working together, we are identifying food trigger. We’re challenging food, but at the end of working together, it is about expanding the diet. Your diets. For anyone listening, you know the end goal is to identify your trigger and then expand your diet, improving Improving gut health does not entail, taking a ton of supplements. So be very careful with supplements. In fact, on the contrary, we usually see supplements messing somebodies gut up. So be very, very careful what you put in your body. Always talk to your health care provider before trialing any supplements, and some of the supplements can also cause long term issues as well. So be very careful what you put in your body. Remember, gut health comes from eating a variety, staying hydrated, exercising, sleeping well, and understanding your own triggers. Okay, I think that’s pretty much it for our episode. Do we have anything else we want to add? No, I.

Brooke Keenan 00:23:19 Think that’s it. That was great.

Jessie Wong 00:23:22 Thank you everybody for listening. We are going to link our resource in the show notes. So if you need help with the low Fodmap diets, go grab our free guide is extremely helpful. If, if you didn’t learn anything from our podcast today, the only thing you need to remember is elimination. Diets are not forever. Identify your triggers, expand your diets, and live a life without gut symptoms. All right. Thank you for listening. Have a wonderful day.

Brooke Keenan 00:23:48 Bye.

Jessie Wong 00:23:49 Thank you for tuning into the IBS nutrition podcast. We hope today’s episode has brought you closer to understanding and managing IBS. Remember, you are not alone on this journey and finding freedom is possible. For more on IBS, make sure to follow us on your favorite podcast platforms and please leave us a five star review! We would really appreciate that you can access links mentioned in this episode in the show notes, to learn more about your type of IPS and how to identify your own food or lifestyle triggers, Register for a free IBS masterclass.

Jessie Wong 00:24:22 Three steps to IBS relief.

Jessie Wong 00:24:25 Holistic three steps approach to managing IBS once and for all. Head to IBS dietician.com/masterclass to register. Until next time, take good care of your gut and here’s to your health and happiness.