General

Low FODMAP diet & IBS

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30 Jun 2016 - General
 

Irritable Bowel Syndrome (IBS) will usually cause abdominal pain/discomfort/cramp, bloating sensation, diarrhoea or constipation. The ROME III criteria will the standard criteria in the diagnosis of Irristable Bowel Syndrome. Sometime, a few other diagnostic tests are required to rule out othe alimentary diseases. IBS is a common disorder that will affect the quality of life.The treatment goal for IBS is to reduce the symptoms and improve the quality of life.

Low FODMAP(fermentable oligo-, di-, and monosaccharides and polyols) diet, is one of the recently proven effective strategy in managing patient with Irritable Bowel Syndrome. Clinical Dietician play a significant role in introduction and managing of this exclusion diets in patient with IBS. 

Is Low FODMAP diet easy to adhere with? Would comppliance be an issue?? 

Hi Ziwei, every hospital or healthcare system will always face some certain deficiency. Sometime, we just need to try our best to deliver best care with limited resource. I believe that there are a lot of health care systems around the world that are lacking the proper service of dietician. Our centre is fortunate enough to have dedicated clinical dietician service, due to the fact that we are dealing with a variety of gastroenterology related diseases like coeliac disease, inflammatory bowel ...
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Hi Jose, Yes you are definitely right, we need a dedicated clinical dietician (with special interest in gastroenterology), in order to prescribe the low FODMAP diet for patient with Irritable Bowel Syndrome (IBS). Dietician need to give detailed counselling, and list of food of exclusion for the patient. Moreover, a close follow up is necessary. There is a whole process of total exclusion of FODMAP diet, monitor improvement of symptoms and then possible re-introduction of certain FODMAP diet, an...
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Hi, You Yi! The main drawback of the Low-FODMAP is that you really need competent nutritionist-dietitians to help you and your patient select and quantify the foods that should be incorporated in the diet. Based on the food list, you have sources for carbohydrates and proteins. How about fats? How do you supply the essential and non-essential fatty acids for the patients? Although most of the fruits included in the list have low glycemic indices, extreme care is still needed when the p...
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Thanks You Yi. I guess so too. The study probably conducted with well trained dieticians. I will make do with what I have. I will probably give them a copy of the diet plan and refer them out to public service dietician. The latter will likely be overwhelmed with patients waiting for their own counselling sessions for other conditions. It is really commendable that you have access to dedicated dieticians who can spend quality time with the patients. Maybe I can work with a dietician to set up a...
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I would use a slightly different strategy for mainly constipation predominant IBS, with the main objective to clear the bowel, and manage constipation with a variety of laxatives or medications or a combination of those. Usually the symptoms will improve once constipation is managed properly. Yes, stress plays a huge factor in patient with IBS, and usually we see a flare of IBS when they are facing stressful event in life. Clinical psychology may have some important role in this, but the acces...
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Thanks You Yi. Should I implement it to constipation type? I do not have a dietician and I will be doing the counselling myself. You did convince me to print out a copy of low and high FODMAP diet to keep in my folder adding to my collection of low purine diet, DASH diet, DM diet and hyperlipidemia diet. I must be glad none of my IBS patient has got gout, hypertensio, DM or hyperlipidemia. They are all young working adults with intense stress in their life. Consultation with them can be exhausti...
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Hi Ziwei, From my experience, low FODMAP diet is very effective in mainly patients with Diarrhoea predominant IBS, or even mixed type IBS. Most of the patients have achieved reduction in IBS symptoms if they are truly adhere to the strict low FODMAP diet. But, this exclusion diet regimen is not easy for some patients, they need to avoid taking the high FODMAP food like wheat, barley, rye, onion, leek, white part of spring onion, garlic, shallots, artichokes, beetroot, fennel, peas, chicory, pist...
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HI Youyi. How effective is low FODMAP diet? I understand a high FODMAP diet contains carbohydrates that are hard to digest and a low FODMAP diet is advised. However, is that a level of evidence to it ? Is this suitable for all forms of irritable bowel syndrome i.e constipation type, diarrhea type and mixed type. I do find it extremely difficult to manage irritable bowel syndrome and they are have repeated visits. Some may have stress issues and presents with frequent dyspepsia, tension headache,...
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