“Any food allergies?” the nutritionally woke waitress asks with a smile as she takes our order. “Why yes,” I answer, “Do you have any dishes without fermentable short-chain carbohydrates?” Smile fades to furrowed brow. “Uuuuuum, let me talk to the chef and see what we can do.” If you have ever tried the FODMAP diet, you know how real this imaginary interaction can seem. FODMAP stands for, Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. Studies suggest it can provide symptom relief for up to 80% of people with Irritable Bowel Syndrome and it was recommended to me by my gastroenterologist. Unfortunately, attempting this multi-step elimination diet can also result in what my family affectionately calls, “Irritable Mom Syndrome.”
What is the FODMAP diet?
The FODMAP diet requires eliminating foods with these fermentable short-chain carbs for a few weeks and then carefully introducing them back into the diet while monitoring symptoms. This sounds straight-forward, but except for lactose and specific grains (wheat, barley, rye), it’s difficult to know what exactly to eliminate because high FODMAP foods exist in all food groups and many are considered nutritious. There are plenty of lists (and podcasts and cookbooks) to reference for help, but I found these resources to be incomplete, contradictory, and confounding. Soft cheeses are out – except for brie and feta. Bananas, squash, and nuts can be found on both low and high FODMAP lists, depending on ripeness, seasonality, and serving size. Some “avoid” foods are found in practically EV-ER-Y THING! Two prime examples – garlic & onions.
For me, all the well-meaning advice (plan ahead, cook at home, bring leftovers to work) felt futile in the face of attempting this diet while traveling for work. It’s difficult enough to avoid dairy, wheat, barley, and rye. Add on the shape-shifting collection of other foods to avoid and I often found myself compromising the rules or eliminating entire food groups. The only commonly served foods I felt I could safely eat were chicken and rice. Plain chicken that I couldn’t be sure was made without garlic and onions, and plain white rice that could easily have been made with butter. Avoiding most of the produce I was served at meals with colleagues made it awkward as I advocated for increased consumption of fruits and veggies as a part of my work.
A Different Pathway to Answers
To nobody’s surprise, my symptoms persisted, and I gave up on FODMAP. Ultimately, I was tested by my gastroenterologist for allergens to more confidently rule foods in or out. Fortunately, gluten is in and sadly, lactose is out. But at least now I know. The GI also tested for and ruled out more severe conditions including ulcerative colitis, Crohn’s disease, and colon cancer. Now that I have some answers, I am experimenting with other variables that seem to make a difference. For example, I now avoid crudité and opt for cooked veggies instead. This makes ordering at a restaurant easier, too. My answer to the soup or salad option is a no-brainer. Soup for me. Unless, of course, it’s cream-based soup…sigh!
Something Venture, Something Gained
The elimination diet I attempted was unsuccessful for me, but the experience made me empathize with people whose allergies trigger anaphylaxis and those who suffer with the aforementioned worse conditions. IBS is disruptive and frustrating, but I’m learning to manage. When I shop, I use Guiding Stars to find the most nutritious option among items that don’t trigger symptoms. When I cook, I try to prepare meals that allow my family to customize their dishes to our individual needs and tastes. When I travel, I avoid lactose and do my best to eat as simply as possible, recognizing it’s only a short-term dietary disruption. I continue to test, learn, and adapt my diet and contingency plans as my work and family commitments dictate.
- Have you ever tried FODMAP or another elimination diet?
- Do your work or family commitments ever make it difficult for you to follow a special diet?
- What have you found that works for you?