How to get to grips with your gut problems

IBS symptoms can be treated with the Fodmap diet, which eliminates short-chain carbohydrates such as wheat, rye, onions and artificial sugars.

Many of the one-in-five Irish people who suffer the painful symptoms of irritable bowel syndrome (IBS) have turned to medication for relief, but the key to keeping the condition in check is diet.

Changing what you eat, rather than taking medication, is the best way to treat IBS, according to two dieticians who have co-authored Gut Feeling, a new book designed to help people manage a sensitive gut.

Lorraine Maher and Paula Mee have both seen patients whose lives have been turned upside down by IBS symptoms, which can range from bloating and pain to diarrhoea and constipation.

While it is not a life-threatening condition, it is certainly a life-limiting one, Lorraine Maher tells Feelgood.

Many people feel awful and their symptoms consistently interfere with their enjoyment of food.

For others, it can lead to depression and, in some severe cases, even thoughts of suicide, she said.

However, both dieticians noted excellent results when they asked their patients to follow a low-Fodmap diet, an eating plan that was developed in Australia in 2001.

Since then, a number of studies have yielded results so encouraging that several national bodies, including the Irish Nutrition Dietetic Institute, have incorporated the diet into guidelines on how to cope with IBS.

Fodmap is an acronym that stands for a range of carbohydrates that are difficult to digest; they are also rather difficult to pronounce, but here’s what it stands for: Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols.

In simpler terms, those short-chain carbohydrates are found in wheat, rye, onions and garlic, pulses, some dairy products, certain fruit and vegetables, and artificial sugars.

Lorraine Maher says people with symptoms of IBS often tend to cut out whole food groups without any real evidence.

That can deprive them of certain nutrients, but it won’t necessarily solve the problem.

The authors offer an example: if you felt unwell after eating a stew of chicken, onions, carrots and rice, you might be inclined to think the rice was the culprit when in fact, onions have been shown to be one of the biggest triggers of IBS.

The first step in trying the Fodmap diet is to eliminate high-Fodmap foods, or some of them, under the supervision of a dietician.

“Everyone has a different symptom profile, so it’s every important to do this with a Fodmap-trained dietician — that can make the difference between getting an accurate outcome or not,” says Maher.

After a number of weeks, certain foods are reintroduced gradually to help identify trigger foods.

After that, your dietician can develop a personalised modified diet to ensure that problem foods are excluded, but that your diet is not nutritionally compromised.

The whole process can take between two and eight weeks depending on the symptoms.

Both Lorraine Maher and Paula Mee found the diet offered real relief to patients, but there was a drawback.

“I had brilliant outcomes but people told me that they found it tricky and hard to maintain as their diet had become so boring,” Maher says.

A low-Fodmap diet can exclude a lot of staple foods such as bread, pasta and dairy products.

To address the issue, both dieticians started to build up a bank of Fodmap-adapted recipes so that their patients could follow a gut-friendly diet that was not short on nutrients, or taste.

One hundred of those recipes are included in Gut Feeling, a beautifully illustrated book that brings you from breakfast, through lunch and afternoon snacks to dinner.

There’s a really good section on stocks, dressings and sauces which is one of the toughest challenges when following the diet as most supermarket or cookbook options are excluded, at least in the first stage of the diet.

The book also has tips on planning, shopping and cooking as well as a helpful swap list, listing foods to avoid and suggesting alternatives.

However, it’s really important to do the diet with the help of an expert as Fodmap lists are constantly being reviewed and updated, Lorraine Maher says.

“People can feel isolated and embarrassed by symptoms of IBS but we hope this book will raise awareness that there is a really effective diet that you can try with the support of a dietician.”

• Gut Feeling is published by Gill Books, €19.99.