Dr. Erin Hendriks

Low FODMAP isn’t forever (and here’s why)

Despite how often it’s mentioned, eating low FODMAP is a phase, not a daily diet like it’s so often portrayed.

Published:

November 11, 2022

Written by:

Medically Reviewed by:

Dr. Erin Hendriks

Board-Certified Physician

Published:

November 11, 2022

Nutrition
Nutrition
From Our Doctors
From Our Doctors

Is FODMAP a familiar acronym? If you have irritable bowel syndrome (IBS), it probably is. It stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. In short, FODMAPs are short-chain carbohydrates that often make IBS worse. They’re found in everything from apples to soup, so avoiding them can be tough. For many people, however, low FODMAP eating is the key to managing symptoms. 

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Here’s the thing though: Despite how often it’s mentioned, eating low FODMAP is a phase, not a daily diet like it’s so often portrayed. The FODMAP process has multiple phases, and cutting back on FODMAPs is only the first phase. 

To do low FODMAP right:

First: Get rid of FODMAPs (temporarily!)

To start the FODMAP process, eliminate high FODMAP foods.  At this point in your FODMAP journey, it can help to bring a dietitian or nutritionist on board. The doctors and health coaches at Salvo Health, for example, can offer guidance, explain which modifications may be a good fit for you, and help pick some great recipes.

Though it can feel complicated, the elimination phase gives your body a break from foods that might be worsening your IBS. The phase usually takes between four and eight weeks to complete. 

Next: Start eating FODMAPs again (a little at a time!)

Then you slowly put FODMAPs back onto your plate, one type at a time. Reintroduction helps highlight which FODMAPs are best and worst for you. (You might uncover an unexpected sensitivity to lentils, for example.) The FODMAPs that worsen your symptoms most are the ones you’ll be continuing to avoid in the future. 

The reintroduction phase also gives you insight into which FODMAPs you can tolerate. Gradually you can start enjoying these as part of your everyday eating. You may make some surprising discoveries during this phase. Perhaps gluten isn’t a problem for you and you can eat bread after all. Or maybe mushrooms or garlic don’t hit as hard for you as they do for others. You may even find out you can drink coffee and enjoy chocolate!

You’ll most likely discover that optimal eating with IBS isn’t just a matter of following a “eat this not but not that” list – rather, it’s a nuanced overall way to meet your nutritional needs.

Why not just keep eating low FODMAP?

Truly low FODMAP eating is only meant to last for a month or two months, tops. If you tried to cut out all or most FODMAPs for longer, you might: 

A genuinely low FODMAP eating style can be quite challenging to maintain. You might also become bored with only eating low FODMAP, and may consciously or unconsciously break your eating habits, which could lead to erratic symptoms. Alternatively, you might become very focused on your meals, which might make you more anxious. This in and of itself could make IBS worse. There is a lot of overlap between IBS and different eating disorders like anorexia. Having IBS can lead to developing an eating disorder and vice versa.  

Don’t forget that when you eat, you’re feeding your gut bacteria, too. And they need a broad range of foods, including some that are higher FODMAP. If you skip these foods for too long, you may starve helpful bacteria colonies and cultivate unhealthy bacteria.

Over time, if you follow only strict low FODMAP eating, you might notice yourself getting more tired, having more headaches, constipation, muscular weakness, or getting sick more easily. These are all signs of potential vitamin and mineral shortages. For example, people can develop a magnesium deficiency, which could lead to muscle cramps and tremors. 

How to reintroduce high FODMAP foods again

There are many different strategies for reintroducing higher FODMAP foods. The gist is that you’ll put one category of food back onto your plate at a time, giving yourself a week or two per FODMAP category. For some people, only a few foods are actually problems, with the rest being pretty well tolerated. 

Depending on whether you've tried FODMAP, or are currently eating FODMAP, your Salvo Health doctor may suggest other food plans that can be compatible with IBS. For example, Salvo Health Clinical Advisor Dr. Mark Pimentel’s Low Fermentation Eating plan advises skipping fibrous or difficult-to-digest foods and non absorbable sugars; it also advocates proper meal spacing. 

Once you know more about what FODMAPs work well for you and which are problematic, you can build a personal eating plan. This means that:

  • You’ll likely feel more energetic, upbeat, and in control
  • You’ll feel more confident (no more playing “IBS food roulette”)
  • You can make recipes to your specific needs
  • You may feel less stress and anxiety, which could reduce your IBS symptoms 
  • You’ll have arrived at a sustainable, healthy way of eating you can commit to for the long run

When you complete the FODMAP process, you end up with an eating plan calibrated  just for your and your body’s unique needs. The majority of people doing this get positive results.

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To sum it up, low FODMAP eating is a temporary phase best completed with a professional’s help.

Get more support from Salvo Health

At Salvo Health, our digital healthcare platform and virtual clinic provides you with continuous text-based support and care for your chronic condition. Imagine being able to text a board-certified Physician or Behavioral Health Coach to avoid flare-ups or manage your pain. Alongside messaging-based communication, members receive a customized Care Plan that can take account of how their symptoms can be managed, no matter what FODMAPs they eat. 

Get immediate access to a coordinated Salvo Health care team, including a certified gastro specialist and board-certified health coach when you join Salvo Health today.

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Dr. Erin Hendriks is an expert in nutrition for a healthier gut.

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