IBS Awareness Month - what if the Low FODMAP Diet isn't working?

by Anne Myers-Wright RD/APD

Posted on Apr 8, 08:54 AM in and . No comments.

What if the low fodmap diet isn’t working? You’ve been on the elimination phase of the Low FODMAP diet and it doesnt seem to be working. What’s going on?

Firstly, it’s really important to come to terms with the fact that the Low FODMAP elimination may not mean that you have 100% symptom reduction. For many, the result is a reduction in symptoms rather than a total disappearance. If you have a reduction in symptoms, you can look at this as a success. So you can get a better picture of whats going on, it’s a good idea to complete a “rate my symptoms” sheet before you start, so that you can rate any improvements following the trial. We can help you with this.

If nothing seems to be improving there are a few reasons why the Low FODMAP diet may not be helping:

You may be “hypervigilant” to symptoms

Some people are so affected by their IBS and have such “super-sensitive” guts that they are anxious and hypervigilant to any symptom, watching out for and focussing on them. Small amounts of bloating or wind are actually normal for most people.

You may have some FODMAPs sneaking into your diet

It’s actually quite easy for these to sneak in. It’s a good idea to complete a food and symptom record so your dietitian can check this.

There may be other food triggers in your diet

These can include alcohol, fatty foods, spicy foods, not drinking enough water or even large portions. Once again, the food diary is a useful tool to discuss with your Dietitian.

Other factors may be at play

Even we Dietitians acknowledge that it’s not always diet causing problems. Other factors such as stress, lack of sleep or anxiety are major IBS symptoms triggers. Think about whether these could be a problem for you and chat to your dietitian about this.

Constipation ruins everything

Ok, that’s a bit extreme but constipation is a real nuisance when you are on the Low FODMAP Diet. If you are suffering from constipation, this could be causing other symptoms (e.g. wind and bloating) so you will need to sort that out first. Make sure to include suitable amounts of the “safe” Low FODMAP fruit and vegetable portions at each meal.

The problem may not be FODMAPs.

If you have worked through the Low FODMAP elimination phase and have looked at all of the other features above with no relief; it may be time to consider that the problem may just be something else. (i.e. not a FODMAP issue at all). Don’t just stay on the Low FODMAP Diet for ages hoping it will help. If it doesn’t make a difference, move on, it’s not for you. Your Dietitian can discuss investigating other possible reasons for your symptoms (e.g. SIBO, food chemical intolerances or other digestive issues)

If you would like to discuss how our specialist dietitians can help with your IBS management, please contact us. We offer a package of care suited to your needs

Tags: Alcohol, Amines, Bam, Caffeine, Constipation, Dietician, Dietitian, Elimination Diet, Fatty Food, Fodmap Diet, Fodmaps, Fodmap Trained Dietitians, Ibs, Ibs Triggers, Salicylates, Sibo

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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