IBS is a functional bowel disorder of multifactorial origin. People with this syndrome may experience changes in bowel movements such as diarrhoea, constipation, flatulence, abdominal pain and distension, nausea, and a consequent decrease in quality of life.
These patients suffer from a dysfunction in the digestion of the small intestine, and when food reaches the colon, it ferments because the small intestine was unable to digest that particular food. In the colon, a “confusion” of the microbiota occurs, resulting in associated symptoms. The Low FODMAP diet adjusts the doses of each food to the digestive capacity of each intestine.
It includes three treatment phases, the first of which consists of removing specific foods considered highly fermentable for a maximum period of six weeks, as they can aggravate the symptoms mentioned above. The main objective of this first phase of the diet is the reduction of gastrointestinal symptoms.
There are several food groups that are eliminated in this phase, such as a wide variety of fruits, vegetables, nuts and seeds, legumes, onions, garlic, some sweeteners, some cereals, spices, and foods rich in lactose, for example.
It is important to note that this first phase of the diet should not be followed indefinitely, since restricting several food groups for a prolonged period of time may lead to nutritional deficiencies in iron, vitamins B9, B12, calcium, vitamin D, and magnesium.
Once the symptoms have improved, the patient can move on to the second phase of the diet, which may last two to three months. In this phase, it is crucial to gradually reintroduce the foods eliminated in the first stage of the diet. Foods should be introduced individually, and tolerance to each one should be carefully tested. This is a phase in which the patient should be monitored more regularly so that they can safely introduce foods, always paying attention to the symptoms that are developing.
Once the testing phase is complete, the patient can move on to the final stage of the diet: the introduction of tolerated foods and personalization, in which an individual meal plan will be developed according to the patient’s tolerances, always taking into account the person’s preferences, habits, and culture.
Throughout all phases of treatment, micronutrient monitoring should be carried out with the necessary dietary adjustments.
It is worth noting that the Low FODMAP diet should always be guided by a specialized professional who can guarantee the individual nutritional needs of each person in order to improve their health status and quality of life.
Dra. Marina Augusto Estevão is a nutritionist at HPA Group
