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Comment by pasbesoin | Hacker News Reader

FODMAP

My father recently had a doctor point him towards this -- for a condition significantly more troublesome than many apparent symptoms with non- or non-diagnosed celiac gluten sensitivity.

He took a look at the diet's do's and don't's, and ruled it out. What would he eat? (And he and my mother have eaten pretty darned healthily, up to now -- pre FODMAP recommendations.

So, is FODMAP real? Or is this the next "gluten free"? Because it rules out a LOT of what we've considered to be a healthy and healthily diverse diet.

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FODMAP is real, most of the people I know who are on the diet where it has helped have SIBO (small intestinal bacterial overgrowth). The problem is that SIBO can have a bunch of causes. Mostly what I hear is that they get the antibiotic and whatever underlying cause can't be found or fixed so they get put on a low-FODMAP diet to stop the bacteria from growing out of control. Doesn't work for everybody, guess it depends on your gut bacteria and what they can survive on, but it seems to work for enough people that doctors recommend it.

Thanks. I think I need to nudge him to do some more of his own research. He definitely needs anything that may help.

I actually had SIBO a while back. Several years ago I had a terrible GI doctor who kept saying all my symptoms were in my head. I eventually got to the point where I weighed less than 100lbs and was constantly sick despite being desperate to stomach anything without falling ill. She would just shrug all this off and tell me nothing was wrong. Eventually I switched to a better doctor who immediately diagnosed me with SIBO, and further testing showed that I was genetically incapable of producing fructose transportation enzymes in my small intestine. Of course most things that contain fructose are high in many other sugar alcohols that ferment in the large intestine and cause an over growth in bacteria that thrive in this environment. After my old doctor was discovered to have nearly killed an infant with her refusal to actually do her job, we filed a complaint. Of course MultiCare swept everything under the rug and did nothing...

It's definitely real. My wife's gastroenterologist put her a low-fodmap diet after she come in for digestion issues. It worked very well (she had to keep a food diary for a month).

The problem is as you suggest, the diet is far too limiting to really be sustainable in the long run. Most Americans grew up eating the restricted items every day. So it's pretty hard to replace things like onions, garlic, peanuts, and dairy in their diet.

For what it's worth, some people on a low-FODMAP find they can have garlic, but not onion—and that can make a huge difference in cooking. Might be worth an experiment.

FODMAP is an elimination diet that's meant to be a base into which you can reintroduce food types in a controlled manner (thus figuring out your specific must-avoid foods).

It's totally doable for medium durations and meant to be amended / tweaked.

A funny thing about the low-FODMAPs diet is that it's not just one thing, in practice. I know several people who follow it, and each has customized it differently as they learn more about what their body tolerates. There's also some degree of flexibility; maybe you find you can eat beans as long as you strictly avoid garlic, for instance, or vice versa. (To some degree it appears to be a numbers game.)

https://www.monashfodmap.com/about-fodmap-and-ibs/high-and-l...

Looking at the foods here, not sure it's counter to what we've considered a healthy diet. Legumes would be about the biggest exclusion on the generally healthy list. The low FODMAP food list doesn't look too restrictive at all though ?

> The low FODMAP food list doesn't look too restrictive at all though ?

Lots of what you'd want from a healthy diet is on it, but, if you try to prepare a meal with varied ingredients, you'll rapidly find that it still has plenty of (sometimes surprising and unexpected) exclusions. Well, maybe that's just me; I find the idea of leaving fruit and onions out of my diet difficult even to conceive.

but if the fermenting sugars in fruit and onion give you incredibly painful ibs, would you try it for a couple weeks to see if symptoms go away. a low fodmap diet is a diagnostic tool.

It's definitely not just you. I had a hell of a time building a low FODMAP menu because of the restrictions. We ended up eating very basic meals consisting of some meat, plain salted rice, and some approved veggie.

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