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What To Do When The Low FODMAP Diet Does Not Work

If you are still experiencing uncomfortable gut symptoms despite following the low FODMAP diet to try and manage your IBS, you are not alone.


You might be surprised to know that there are many factors that could be contributing to why the low FODMAP diet has not worked for you. This is where it is important to revisit your approach to the diet and consider some possible reasons why it may not have been effective for you.


Here are some factors to consider to help you troubleshoot:


1. You are following the diet incorrectly. The low FODMAP diet is complex, and it's important to understand the nuances of the diet to get the best results. It's possible that you may have misinterpreted the diet or accidentally be consuming high FODMAP foods. You may also be using inaccurate resources without realising.


2. You may have other food intolerances. While the low FODMAP diet can be effective in reducing symptoms in up to 80% of people with IBS, it is not a one-size-fits-all solution. Other food intolerances such as food chemicals (salicylates, amines, glutamate and additives) or whole proteins (wheat, dairy, soy) could be contributing to your symptoms.


3. Your lifestyle habits may be causing your symptoms. These include your eating habits, sleep hygiene, stress management and movement. It is important to consider the role that these may be playing in your symptoms. If you are eating quickly, skipping meals, having poor quality sleep, doing high intensity exercise and feeling stressed, these can all exacerbate your symptoms independent of the type of food you are eating.


4. You are having too many gut irritants. These include fatty food, fizzy drinks, alcohol, caffeine and spicy food. These can irritate the nerve endings throughout your gut and because people with IBS already have sensitive nerve endings, something called visceral hypersensitivity, this can exacerbate your symptoms.


5. You may have poor gut health. This can be due to overly restricting your diet, which can cause a decrease in the diversity and amount of different gut bacteria that you have. This can cause an increase in uncomfortable gut symptoms, independent of those you may be experiencing with your IBS. It can also decrease your tolerance to foods, so you are likely to feel like you are reacting to everything you are eating.


6. You are taking unnecessary supplements. Many supplements can contain gut irritants or high FODMAP ingredients which can trigger gut symptoms in people with IBS and there is limited evidence for their use in IBS. They are also not regulated like prescription medications, which means that they do not even need to prove that they work.


7. You have another condition with similar symptoms to IBS. If your symptoms persist despite following the low FODMAP diet and making other dietary and lifestyle changes, it is important to speak with your doctor to rule out other medical conditions such coeliac disease or inflammatory bowel disease. Your doctor can help you explore other potential causes and treatment options.


Remember that everyone is unique, and finding the right approach to manage your specific IBS symptoms may take time and patience. This is why it is important to work closely with a specialised IBS dietitian, like myself, who has more experience working with complex clients and really explores and dives deeper to help you troubleshoot and get to the underlying cause of your symptoms once and for all. This ensures you get personalised support and guidance and develop a tailored action plan to your specific situation so you can find relief from your IBS symptoms quicker.

 

If you’re ready to start taking control of your IBS and breaking free from uncomfortable gut symptoms in as little as 2 weeks, CLICK HERE to watch my FREE 60-minute Masterclass to discover the biggest and most surprising mistakes stopping you from finding IBS freedom and what you can do instead.

 

References

  1. Gandy J & the British Dietetic Association. Manual of Dietetic Practice–Fifth Edition. 2014: 460-466.

  2. Gibson PR, Shepherd SJ (2010). Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology. 25: 252–258.

  3. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006). Functional bowel disorders. Gastroenterology. 130: 1480–1491.

  4. National Institute for Health and Care Excellence (NICE) (2008). Irritable bowel syndrome in adults: Diagnosis and management of irritable bowel syndrome in primary care. CG61.

  5. Tuck C & Barrett, J (2017). Re-challenging FODMAPs: the low FODMAP diet phase two. Journal of Gastroenterology and Hepatology. 32 (Suppl 1): 11–15.


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