How we helped "Sarah" live a better life with IBS – part 2- Sarah goes Low FODMAP.

by Anne Myers-Wright RD/APD

Posted on Jul 11, 10:46 AM in . No comments.

Sarah* had come to see us at AM Dietetics after being diagnosed with IBS-D (diarrhoea dominant IBS). Her symptoms included bloating, wind, gut pain, cramping, diarrhoea, and frequent trips to the toilet. Sarah was hoping to go on the Low FODMAP Diet, in order to reduce her symptoms.

As mentioned in our previous blog, Sarah first had a few “first line” changes to make to her diet, before even considering the Low FODMAP Diet. She spent a few weeks making changes and felt a lot better. She had:

- Fewer trips to the toilet
- Less pain and cramping
- Bonus : more energy

But, even though things were better, her stools were still quite loose and there were some issues with urgency and bloating…so we decided to move to phase 2, the Low FODMAP Diet.

Sarah had heard about the Low FODMAP Diet but didn’t really know that much about it. She had thought that it was a long term “diet for life” and hadn’t realised that it is actually an elimination and challenge protocol.

We explained that the Low FODMAP Diet comes in three phases:

Stage 1: 4-6 weeks low FODMAP exclusion/elimination diet
Stage 2: Structured reintroduction of FODMAP-containing foods
Stage 3: Long-term dietary personalisation

Dietetic Advice

In this visit with Sarah, we explained all about FODMAPs – how they might cause IBS symptoms, where they are in the diet and how to identify them in foods and products.

We also explained

-which foods and drinks were Low FODMAP and could be included as part of the elimination phase
-which low FODMAP foods might trigger IBS symptoms despite being Low FODMAP
-safe portions of Low FODMAP foods
-the importance of including fibre in the plan
-how to work this all into a balanced exclusion/elimination diet
-how to complete the food and symptoms diary
- the importance of keeping going with “first line” strategies (e.g. regular meals, stress reduction etc)

We answered Sarah’s questions and she started the Low FODMAP Diet.

4 weeks later

Sarah was thrilled, she was one of the 75% of people who the Low FODMAP Diet works for. The Low FODMAP Diet has made a huge impact on her symptoms. She had formed stools (and had even taken a photo, she was so happy). Her cramping had gone and she had been able to reduce her bloating quite a lot. Sarah was able to make plans for her work and life. It was looking good.

The problem was that Sarah wanted to stay on the elimination diet. She was really nervous to challenge individual FODMAPs in the next phase.

We explained the importance of challenging FODMAPs in the next phase:

Firstly, why cut foods out when you may not even have to! Sarah may have found that there were only one of two FODMAPs causing her problems.

Secondly, following the elimination phase long term could be damaging to the gut microbiome and generally in terms of variety and fibre intake.

So we convinced her to go for the next phase – the challenges.
We gave Sarah a protocol to follow to try each FODMAP in turn…and waited until her next visit to see how she got on.

Click like and share for this post and for part 3 to see how Sarah went with the challenges.

*“Sarah” gave their permission for us to tell their story. Certain details have been changed to retain their anonymity.

Tags: Challenge Phase, Challenges, Elimination Diet, Exclusion Diet, Fodmap Challenges, Fodmap Exclusion, Ibs, Ibs-D, Low Fodmap Dietitian, Microbiome, Monash Dietitian, Symptoms Relief

About the author

Anne Myers-Wright

Anne Myers-Wright RD/APD

Anne is a Health Professions Council (HPC) registered dietitian (RD), an Accredited Practicing Dietitian (APD- Australia), a fellow of the Higher Education Academy (FHEA), a member of the British Dietetic Association, The Nutrition Society and of The Dietetics Association of Australia.


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