top of page
Writer's pictureAnna Olivieri

How Restrictive Diets like Low-FODMAP Can Backfire For People With IBS

Updated: Oct 29



For those diagnosed with Irritable Bowel Syndrome (IBS) the first treatment they often try is cutting out certain foods. A common diet recommended for IBS is the low-FODMAP diet. A Low-FODMAP diet involves restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for at least 4-8 weeks and then methodically reintroducing foods.


The Low-FODMAP diet is highly restrictive and requires cutting out foods like onions, garlic, wheat, beans, dairy, apples, bananas, avocados, and honey, to name a few. These foods are more fermentable meaning they create gas when they are broken down, which is a normal, healthy part of the digestive process.


But for people with IBS, the added pressure from the gas on the nerves in the intestines can cause pain and digestive symptoms. So eating High-FODMAP foods that produce more gas can trigger symptoms.


The problem is that IBS is not caused by the foods we eat. Research shows that IBS is a disorder of the brain-gut interaction, often stemming from a nervous system under chronic stress (1).


When the stress response is activated, our body diverts energy away from the digestive process and towards functions that are critical for survival, temporarily disrupting the digestive process to focus on addressing the perceived threat ("fight or flight"). However, when the stress response is turned on too much or for too long, this can disrupt our digestion on a chronic basis, creating IBS.


Chronic stress can also disrupt how we perceive the sensations of the digestive process. For people with IBS, the nerves within the intestines are oversensitive and are more likely to generate pain in response to stimulation, like food or gas in the digestive tract.


Cutting out High-FODMAP foods from your diet may help to some extent because the less gas is created, the less the oversensitive nerves in the gut will be stimulated. However, the food itself isn't the root cause, it is the oversensitive nerves.


To treat IBS, you have to target the root cause which is the brain-gut connection. This is the focus of therapies like Pain Reprocessing Therapy, Emotional Awareness & Expression Therapy, and Gut-Directed Hypnotherapy.


How Low-FODMAP Can Backfire


I did the Low-FODMAP diet for over a year when my pain and symptoms were severe and I was desperate for relief. It was difficult to adhere to and required a lot of forethought and vigilance around every meal I ate. It made eating out nearly impossible and social outings more stressful.


Initially, I found my symptoms improved somewhat -- something that I now attribute to my brain feeling safer by having a clear list of "safe" foods. Adhering to the diet over time became more stressful and began to take a mental toll, I noticed any positive effects started to wear off. It felt like I was back at square one with my symptoms.


For me, it wasn't until I discovered the mind-body approach and Pain Reprocessing Therapy that I was finally able to finally be free of my symptoms completely.


Side note: I do not endorse doing the Low-FODMAP diet for as long as I did. Ideally, we want to strive for a varied diet with lots of plant foods that promote digestive health and a diverse microbiome. The Low-FODMAP diet restricts many of these healthy foods and is thus not meant to be followed long-term.


The highly restrictive nature of the Low-FODMAP diet and the anticipatory anxiety of the reintroduction process can inadvertently add a lot of stress onto individuals who are (consciously or not) dealing with a high level of stress already. For this reason, pursuing a restrictive diet can add fuel to the fire of IBS.


Ultimately, you know your brain and body best and need to make the right decision for you and your healing. This may involve modifying your diet. But I caution you to be aware of any added pressure and hypervigilance that dieting may be adding to your plate. Pay attention to how it makes you feel emotionally.


Healing from IBS is not just about physical modifications, your brain and nervous system play a key role in its development and perpetuation. Making your nervous system feel safer is an absolutely critical part of the process. When we start to view a large number of foods as "dangerous", this can have the opposite effect.


As always, talk to your doctor or dietician before starting any new dietary intervention.


Sources:

  1. Coss-Adame E, Rao SS. Brain and gut interactions in irritable bowel syndrome: new paradigms and new understandings. Curr Gastroenterol Rep. 2014 Apr;16(4):379. doi: 10.1007/s11894-014-0379-z. PMID: 24595616; PMCID: PMC4083372.

12 views0 comments

Comments


bottom of page