Briefly a low FODMAP diet restricts foods that contain certain types of carbohydrates, specifically fermentable carbohydrates. However, though a low FODMAP diet is certainly a useful tool to help manage the symptoms of irritable bowel syndrome, it is not a cure for this complex condition. In fact, research shows that the low FODMAP diet only helps around 60 to 80% of people with IBS.
There are several reasons that a low FODMAP diet may not be entirely successful in relieving symptoms. To uncover the underlying factors can entail a bit of detective work, with careful consideration of the individual circumstances that might be responsible.
Assuming that the low FODMAP diet has been followed closely, it is necessary to look at some reasons why the diet may not be successful. For example, it is important to have an up to date and accurate list of FODMAP foods. Otherwise, since many foods contain FODMAP carbohydrates it could be that some foods that contain FODMAPs are still being eaten.
Another way that the low FODMAP diet may not be successful is because it relies on restricting the amount of certain carbohydrates. So, eating large, infrequent meals can be problematic as this can equate to eating a high intake of FODMAPs at one meal.
Eating out can also be problematic. When eating out, serving sizes might be larger than you might prepare for yourself. Plus, food choices are likely to be limited, or meals may contain FODMAP ingredients that are not included in the description.
Similarly, when grocery shopping, many processed foods contain ingredients that have not yet been tested for FODMAP content. Likewise many contain ingredients that may be difficult to identify due to differences in food labelling, making FODMAP avoidance difficult.
Some ways to limit these potential problems include having a detailed list of FODMAP foods such as the food list created by Monash University. Eating smaller and regular meals, prepared at home from fresh ingredients, and avoiding processed or convenience foods. It is best to minimise eating out where possible, or choose simply prepared meals made from low FODMAP ingredients.
Some tips for low FODMAP meal choices when eating out include choosing plain, protein based meals of meat, poultry or fish, with vegetables, salad, and potatoes or rice. Choose gluten free options, without sauces, and ask for dressings to be served separately.
If, after addressing these potential pitfalls, there are still ongoing symptoms, it is advisable to seek professional advice from your doctor to rule out other conditions that have similar symptoms.