The low FODMAP diet is a brilliant dietary approach for many people with IBS and IBD. However, it is also quite complex and so an experienced dietitian is definitely needed in order to guide the client through.
Unfortunately, there seems to be a culture in the UK of GP’s providing patients with a 1 A4 page handout and being told to ‘have a go’, individuals using inaccurate online sources and even many going undiagnosed with other digestive health issues.
This article outlines the importance of seeking out an experienced dietitian in order to guide an individual through this complex dietary approach.
1. You may not have been diagnosed correctly. I see many people in clinic who have not yet had the correct tests and simply putting them on the low FODMAP diet may prevent them from getting a proper diagnosis. Remember, digestive symptoms may even be the result of bowel cancer, coeliac disease or inflammatory bowel disease and so getting the correct diagnosis is very important.
2. You may have an allergy. Whilst true allergies are rare, they do exist and there are even some called non-IGE mediated allergies which you can not test for. A dietitian will be able to assess your symptoms and medical history in order to again advise you on the best dietary approach to your symptoms. If you do have an allergy, the low FODMAP diet will not help as it still contains many low levels of allergens. Instead, you will continue to have symptoms and without the help of a dietitian be always wondering if you have accidentally taken in a high FODMAP food.
3. You may not need to do a low FODMAP diet. Whilst very affective for many people, the low FODMAP diet can be complex to follow and high FODMAP foods may not be the underlying cause of your symptoms. There are many cases I have seen where a few lifestyle and general food changes have solved the problem alone without any need for a low FODMAP approach.
4. A low FODMAP diet may make things worse. There are several digestive symptoms the low FODMAP diet can help with but it can also make some symptoms a lot worse. A dietitian will be able to guide you through what is the best dietary approach for your specific symptoms.
5. You are highly unlikely to be following the diet correctly. There is plenty of information on the internet about the low FODMAP diet. However, this is mostly from other countries where foods are made and grown differently, therefore what is in them is also different to the foods in the UK. Some sites even use published research which is out of date or has been interpreted incorrectly.
6. Your diet is likely to become unbalanced. While it is entirely possible to manage a healthy balanced diet on the low FODMAP approach, it is more difficult as you are having to make many changes to your diet. A dietitian will be able to guide you through this process ensuring that all your nutritional needs are met.
7. The low FODMAP diet will cost you more money. Some of the ‘free from’ food alternatives that are suitable on the diet are more expensive and simply switching to these for a period of 4-6 weeks can soon add up. However, a dietitian will be able to advise you on the use of foods which are naturally low FODMAP and so also cheaper.
8. It will take a lot longer which may harm your gut bacteria. If you are having to piece a diet together yourself it is likely to take a lot longer to get into and start seeing any result. FODMAPs are actually very good for us as they play a role in good gut bacteria in the digestive system. At present, we do not yet know what the long term effect of restricting these fermentable carbohydrates will have.
9. The Low FODMAP diet is not a cure, so if you are still having some symptoms when will you come off the diet? The underlying cause of your symptoms whether it’s IBS or IBD will always be there and in many cases there are often some residual symptoms despite the low FODMAP approach. A dietitian will be able to advise you from your diet, lifestyle and symptoms if there is anything else you could be doing and when to come off the diet.
10. Reintroduction is very complicated. After your initial 4-6 week low FODMAP period you will then need to look at reintroducing foods to find out which one was causing your symptoms. This is a very systematic and controlled process where the help of an experienced dietitian is paramount. I have even had people on this process have symptoms which were unrelated to their reintroduction but without having that pointed out to them, they may have gone on to avoid that food forever.
If you would like any further information about this topic or in fact to book an appointment (Skype and face to face both available) to see if the low FODMAP diet can help you, please do not hesitate to contact me.
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