Diet Tips:The super sensitive in IBS

By Caroline Tuck (APD, PhD Candidate)

Irritable Bowel Syndrome (IBS) can express itself in many different ways, resulting in different symptoms that may change over time. Therefore, IBS is not a straightforward condition to treat and the IBS management does not suit a ‘one-size-fits-all’ approach.

There are many IBS treatments available, including medications, dietary change, hypnotherapy and herbal remedies, with varying levels of evidence supporting their use. 

Therefore, two people (even with the same type of IBS – constipation predominant, diarrhoea predominant or mixed) may not respond to the same treatment.

At Monash University, we focus on diet therapies because this is our area of research expertise. We recommend people follow a low FODMAP diet for a short period of time followed by a period of rechallenges, during which higher FODMAP foods are reintroduced enabling people to assess their tolerance to the various FODMAP subgroups. Most people should not need to stay on a strict low FODMAP diet for life. The reason we suggest rechallenging with higher FODMAP foods is discussed in previous blog posts: 

http://fodmapmonash.blogspot.com.au/2015/06/just-2-6-weeks-it-is-not-diet-for-life_8.html and http://fodmapmonash.blogspot.com.au/2015/04/low-fodmap-diet-not-lifetime-diet.html

But for some people, reintroducing foods is not easy or straightforward. In fact, in more sensitive individuals, reintroducing higher FODMAP foods can be very hard. Some people find that symptoms return even if they reintroduce very small quantities of higher FODMAP foods. This may require the person to follow a strict low FODMAP diet for longer to maintain symptom control.

The complexities of treating IBS mean that consultation with a Dietitian is very important, especially in people very sensitive to dietary factors such as FODMAPs. 

How a Dietitian can help:

•          They can suggest other strategies (both dietary and non-dietary) to help improve food tolerance.
•          They can ensure your diet remains nutritionally adequate if you need to remain on a low FODMAP diet for longer periods.
•          They can recommend other dietary and non-dietary therapies that may improve symptoms further.
•          They can identify food triggers other than FODMAPs
•          They can work with your doctor/gastroenterologist to find the best treatment for you.

You may also find this blog post helpful: http://fodmapmonash.blogspot.com.au/2015/05/top-5-reasons-why-you-should-see_22.html

In the long term, we advise that a strict low FODMAP diet is not continued, even in super sensitive individuals. We also recommend you repeat unsuccessful food challenges because IBS symptoms and tolerance to different foods changes over time. Reintroducing foods very gradually can also improve your tolerance.

Diet Tips:Thank you for purchasing our low FODMAP diet app

By Dr Jaci Barrett

It's a New Year and time for us to reflect on 2015. We wanted to take an opportunity to thank those of you that have purchased our Monash University low FODMAP Diet app. It’s not a free app, and for many the price is significant, so thank you for investing in us.

The proceeds from the sale of the app go toward many of our projects. Research funding is scarce, competitive, and difficult to source, especially when the area of research is new. Some of our projects funded by app sales include:

• Testing of foods for their FODMAP content and expansion of our food database  Including local Australian and international foods

• The purchase of laboratory equipment, kits and chemicals

• Research studies and clinical trials we conduct: 

- Assessing the fermentability (gas-producing ability) of fibre supplements

- Manipulating the diet of breastfeeding mothers to relieve the symptoms of infantile colic

- Investigating the neurobehavioral effects of gluten in non-celiac gluten sensitivity

- Alterations in zonulin as a potential biomarker of gastrointestinal dysfunction

- Can cooking times reduce the FODMAP content of legumes?

- Investigating a new diet therapy to reduce symptoms of Irritable Bowel Syndrome


We'll be posting more detailed reviews about some of these studies in the coming weeks, so stay tuned.

We get many emails of support and gratitude from patients with IBS using the diet and app with much success. We hear life changing stories. But without your support and the worldwide interest in what we do, these projects would not be possible and the success of the diet would be limited.


So a big thanks to you from all of us in the Monash University, Translational Nutrition Science Group!