IBS, Gluten sensitivity and Celiac Disease Update


I have been busy studying and reading on the Low FODMAPs diet to assist with the symptoms of irritable bowel syndrome like bloating, excess gas, and diarrhea.  I was surprised these symptoms appear very much like a reaction to gluten ingestion for a person with celiac disease. Sue Shepard, the Australian dietitian that created the Low FODMAPS diet suggests using the diet for persons not only with IBS but for celiacs with on-going symptoms and for non-celiac gluten sensitivity.
What are the FODMAPs?FODMAPs are found in the foods we eat. FODMAPs is an acronym for

Fermentable
Oligosaccharides (eg. Fructans and Galactans)
Disaccharides (eg. Lactose)
Monosaccharides (eg. excess Fructose)
and
Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

Where are FODMAPs found?A few examples of food sources for each of the FODMAPs are listed below. The list is not complete. New data has been obtained through Monash University Department of Gastroenterology regarding the FODMAP content of foods. As a result, there have been some changes from previous food lists. Below is a list containing up-to-date information.
Excess Fructose: Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup
Fructans: Artichokes (Globe), Artichokes(Jerusalem), Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder), Spring Onion (white part), Shallots, Wheat (in large amounts), Rye (in large amounts), Barley (in large amounts), Inulin, Fructo-oligosaccharides.
Lactose: Milk, ice cream, custard, dairy desserts, condensed and evaporated milk, milk powder, yogurt, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils, Chickpeas
Polyols: Apples, Apricots, Avocado, Cherries, Nectarines, Pears, Plums, Prunes, Mushrooms, Sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and Isomalt (953

Go to her website for more information, research and books.
Getting tested for fructose or lactose intolerance with breath tests, to make sure you need all of the limitations is a great starting point. If you need help implementing the diet, let me know I have had a few patients that have used the diet. I have also had a few patients that could not tolerate gluten and fructose. I am continuing to develop handouts, resources and recipes.

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