IBS doesn’t cause physical damage or involve the immune system. At this stage there are no biomarkers or diagnostic tests (blood tests, endoscopy, ultrasound) that can be used to confirm diagnosis. Instead, diagnosis is made by seeing your doctor to exclude medical conditions that may be involved in causing your symptoms followed by considering symptoms in comparison to ROME IV criteria.
Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
- Related to defecation
- Associated with a change in frequency of stool
- Associated with a change in the form (appearance) of stool
NB: criteria should be fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
IBS can be classified into subtypes:
- IBS – C – constipation dominant
- IBS – D diarrhoea dominant
- IBS – M – alternating between constipation and diarrhoea
There are many tests (IgG, hair samples, Vega testing) that are offered by alternative practitioners which claim to identify intolerances. These test lack evidence, are expensive and unreliable. They can also lead to false diagnosis. The gold standard for identifying a food intolerance is an Elimination style diet followed by systematic challenges under the guidance of a specialised Registered Dietitian.
It is not necessary to have a breath test for fructose malabsorption or lactose intolerance. This study from Monash University found that breath tests often give false negatives or false positives. Further, there was little correlation between breath tests and symptoms that were experienced by patients. Since FODMAPs do not cause damage, they only need to be limited if they cause symptoms and the only way to know this is by doing an Elimination diet followed by structured challenges with a specialised Registered Dietitian
No, spicy foods, fatty foods, alcohol, caffeine and carbonated drinks are generally low FODMAP, however these are well known gut irritants. There are other molecules in food that some people are intolerant of (e.g. salicylates, proteins, additives) these can also cause gut upset in susceptible people. If you think this might be you, it’s best to see a specialist Registered Dietitian for personalized advice.
Before starting a low FODMAP diet, you will need to see your doctor and have other conditions that could be triggering your symptoms excluded. Coeliac disease, Inflammatory Bowel Diseases and even some cancers can have identical symptoms to IBS, but require very different treatment.
Once you have determined that you have IBS, the next step is to see a specialized dietitian who can guide you through the phases of the low FODMAP diet and tailor it to suit your needs.
Focusing on what you can eat, makes the low FODMAP diet much more enjoyable. Download our chart of low FOMAP swaps here, check out our dietitian approved low FODMAP recipes here and don’t forget to download the Monash smartphone app and don’t forget to look for the FODMAP Friendly logo when you are shopping.
At The Healthy Baker, we know that IBS can be isolating, so it’s good to get support. A specialized Registered Dietitian is a great start. You can also follow The Healthy Baker social media on Facebook and Instagram and join a closed Facebook group. We recommend Low FODMAP Recipes & Support. This group is well moderated and has specialist Registered Dietitians monitoring it to ensure information is accurate and up to date.
Gluten is the protein in wheat, barley and rye. FODMAPs are the carbohydrate in wheat, barley and rye. They are different molecules that can occur in similar foods. Unlike celiac disease, FODMAPs only need to be limited enough to keep you under your symptom threshold. This means that small amounts of wheat are low enough in FODMAPs to be under the FODMAP cut off. Examples include: Lo-Fo Pantry flours, 1 slice of wheat bread, ½ cup of wheat pasta.
Lactose is a “Di-saccharide” or the “D” in the FODMAP equation. Lactose fee dairy products are low FODMAP and allowed on a low FODMAP diet. Examples include: cheese and butter which are naturally lactase free as well as lactose free milk, yoghurt, ice cream and custard.
No, FODMAPs are water soluble, so they will leech into other food while cooking, making the entire dish high FODMAP.
These are low FODMAP. Since FODMAPs are not oil soluble, they can be infused with the flavour of garlic or onion, without infusing the FODMAPs. Just be careful if you do this at home, garlic contains spores that can develop cause food poisoning. We suggest storing homemade oils in the fridge and using within three days. Alternatively, homemade infused oils can be frozen for safe keeping.