AUTHOR: Dr. Jason Bush
There has always been an intuitive connection between environmental factors like diet and allergic conditions or digestive issues. The sudden onset of symptoms following a meal containing a particular ingredient often resonates with a person, leading us to become familiar with triggers, such as certain restaurants, brands, or cooking styles. The search for solutions has given rise to concepts like the Elimination Diet, in which a number of potentially problematic foods are eliminated from the diet and then re-introduced one-by-one in order to distinguish foods that are well tolerated from those that are not. This deductive approach has proven useful for many people.
In other situations, the cause and effect relationship between triggers and symptoms are harder to pinpoint. Such is the case with various gastrointestinal conditions, including Crohn’s Disease, Inflammatory Bowel Disease, and Irritable Bowel Syndrome. Recognizing that multiple types of foods triggered flare-ups in Crohn’s Disease, Peter Gibson at Monash University hypothesized that fermentable oligo-, di-, and mono-saccharides and polyols (known under the acronym FODMAPs) contained in those foods might be responsible.
These poorly absorbed, highly fermentable molecules put strain on the intestines by drawing water into the digestive tract and rapidly producing gas, which leads to increased intestinal permeability and the triggering of symptoms. Prebiotics like inulin, fructooligosaccharides (FOS), galactooligosaccharides (GOS), isomaltosaccharides (IMO), and xylooligosaccharides (XOS) all fall into this category. Since the development of the Low-FODMAP diet, which limits or eliminates foods containing these compounds, many people adhering to the diet have found significantly improvement in the symptoms associated with their digestive disorders, including those with Small Intestinal Bacterial Overgrowth (also known as SIBO).
While the Low-FODMAP diet may provide relief, it substantially reduces the amount of fermentable fiber (also known as prebiotics) in the diet. This restriction starves the healthy bacteria in the gut, and can lead to constipation and limit the benefits associated with having a healthy microbiome. So how can you adhere to the Low-FODMAP diet while preventing constipation and feeding your healthy bacteria?
Perhaps the easiest way is to introduce a slow-fermenting prebiotic supplement to the diet. Slow-fermenting prebiotics (like digestion resistant starch) are very large chains that gradually break down. This delays fermentation until the prebiotics reach the large intestine and extends gas production over a longer time, which minimizes bloating and cramping. Slow-fermenting prebiotics can also help individuals with SIBO by binding bacteria in the small intestine and dragging them back into the large intestine where they belong.
It is especially important for those on a Low-FODMAP diet to gradually introduce digestion resistant starch prebiotics to their diet because it takes time for the gut microbiome to adjust to this new-found source of nourishment. Since a Low-FODMAP diet may negatively affect the gut microbiome, people on this diet may find that it takes longer for the healthy bacteria to return to the optimal numbers necessary to make efficient use of higher prebiotic doses.
Including a digestion resistant starch supplement while following the Low-FODMAP diet allows individuals affected by digestive disorders to improve their gut microbiome while avoiding triggers. Together, these efforts should lead to significant improvements for those who previously struggled with gut health issues.