AUTHOR: Dr. Jason Granzotto

The Low FODMAP diet is a restrictive diet that often gives patients relief for their irritable bowel symptoms. The FODMAP acronym outlines fermentable sugars that are available from various fruits, vegetables, dairy products, legumes and some grains. Typically patients experience a reduction in bloating and irregular bowel habits by following an initially restrictive diet that can progressively become less restrictive – assuming symptoms do not recur.

Patients report a tiring process of trial and error when reintroducing certain FODMAPs since not all irritate the same way. My perspective points towards a gastrointestinal terrain problem. Is the food the problem? Inherently no, but perhaps if your gut health is suboptimal then certain FODMAPs may be your kryptonite. Surely the solution is not just avoidance. Dietary avoidance in my experience leads to increasingly restrictive diets. Partly because the real issue – Healing the gut – is often overlooked.

If we keep adopting restrictive diets that address food sensitivities, lectins, FODMAPs, etc., eventually we will run out of food. I am speaking tongue-in-cheek but the following are some facts that I have encountered in treating gut health:

i) Digestion starts in the head – our brain, moving from the sympathetic brain of fight or flight, to the parasympathetic rest & digest. If we don’t shut off this crazy brain of ours at some point, nothing works. We can chew the food and swallow but does our brain tell our stomach or even our salivary glands to work? It is a process that we take for granted – I’ll chew now and digest later, this isn’t fair to our gut.

ii) Sugar is a poison – controversial but if the processed stuff doesn’t have any nutritional value beyond calories and we know it can disturb our gut flora by selectively promoting the growth of harmful bacteria & yeast, then why consume it? This disturbance interferes with our natural flora that are necessary for appropriate gut metabolism. We need to protect and promote our flora.

iii) Gut healing is a process – eradicate the bad bacteria, heal the cells of the intestine and stabilize the immuno-inflammation, promote the growth of your gut flora, reduce/avoid foods that disturb your gut flora. This typical protocol is useful and highlights the need for some order in the gut healing process.

Generally, cutting out foods and being too restrictive concerns me. If a short-term modified diet, be it Low FODMAP, or even an elimination diet, does not yield sustainable results once you begin the re-introduction process, then the healing process isn’t complete. Prebiotics, and if necessary probiotics, glutamine, demulscents and enzyme support may be the missing keys. Cutting out foods cannot be the solution. Don’t fall into the trap of making food the boogie-man. In Asian medicine, worry damages the digestive system, as does sugar. I think there is valuable knowledge here, we’d be wise to listen. Heal the gut and then reintroduce, don’t make food avoidance a permanent issue.



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