Recently, I got a few questions from others using a low FODMAPs diet to manage their IBS. With their permission, I’m going to share the Q & A session(s).
I am brand-spankin’-new to FODMAPs and am 1 week into the elimination phase. And totally full-blown into the frustration phase! How long did you stay on the elimination diet and how do you start reintroducing foods? My GI doc put me on this but did not have much info at all.
I did the elimination diet for 2 weeks. It wasn’t too hard because I’m a creature of habit, so once I figured out a FODMAPs free dish that left me feeling ok, I stuck with it. When it came to finding good recipes or meal ideas, though, I didn’t have many resources. For that reason, I can definitely relate to your feelings of frustration. Being (mostly) vegan and no/low FODMAPs is difficult without serious planning.
Since I’m Type A, this is where I can help.
Elimination meal ideas <—this post has an entire menu (breakfasts, lunches, dinners, desserts, & snacks) for over a week of eliminating FODMAPs
I’m hoping to expand on the meal ideas I’ve created in that post to get a decent collection of elimination recipes for those who are no / low FODMAPs, vegan, vegetarian, or a combination of those (like me). Being on a plant-based diet and minimizing FODMAPs is something I’m still perfecting myself, but I may as well share my journey as I go. If you have requests for certain dietary considerations, let me hear them!
As for the challenge phases…
Truth be told, I didn’t have the best organization with these phases and they got really muddled, so if I were doing it all over again, I would definitely follow a more regimented and systematic plan.
1 week of each challenge group – fructose, fructans, galactans, lactose, polyols
Don’t add more than one challenge group at a time.
Return to the elimination diet (until you have returned to your baseline digestive function) in between challenge phases.
Make sure to record EVERYTHING you eat and symptoms you have throughout the process.
Record the times of eating and the times of any noted digestive issues.
Be as specific as possible (where in the gut the pain is, degree of bloating, reflux, bowel habits, etc.). The more detail, the better.
Record the exact amounts of the challenge ingredient you ingested.
After a week, you may start to detect patterns. If you feel like you have a handle on the cause and effect relationship of a FODMAP food, you can move on. Longer challenge phases can really help hone in on the nitty gritty. If you vary how much you challenge your GI tract (FODMAPs load in one meal vs. an entire day), you may start to “learn your gut” but remember IBS is a tricky beast. If you have an episode that doesn’t seem to make sense after what you’ve been experiencing, try not to get discouraged. With IBS there’s never black and white. Minimizing FODMAPs is far from perfect, but it’s at least a huge improvement. The more trial and error you do, the more you will understand. Knowledge is power, so be a GI detective.
Record everything.
I too am a beginner low fodmap dieter in the UK. I am finding it difficult as whatever I stop eating I still get the pain and wind. Does it take a while to get it all out of the system? Am going to the doc next week to see if I can get help there.
Unfortunately, that’s not the experience I had. Once I eliminated all FODMAPs the relief was fairly immediate. After just 2-3 days I felt like a whole new person. After a week of no FODMAPs I thought I had discovered the keys to heaven. I’m sorry I can’t offer more info, but I only have my own experience to go off of. It’s definitely a good idea visit the MD in order to rule out another (potentially serious) GI problem.
I also want to clarify another thing mentioned in this question. The elimination phase is not meant to be LOW FODMAPs. To know if you are truly affected by fermentable saccharides, you should start on a NO FODMAPs diet. As in zero sources of FODMAPs (for at least the first few weeks). As difficult as this seems, it’s crucial to determine if your GI issues are caused by the fermentation of carbohydrates in the gut.
Be honest with yourself and make sure you are 100% dedicated to eliminating every source of FODMAPs. This is especially important if you are eating processed/packaged foods with hidden ingredients (like “natural flavors”).
Now here’s my question for you guys…which challenge group is the worst for you and have you found any ways of eating foods in in these groups that doesn’t cause as many symptoms?
How do you know what’s considered “low” in a low FODMAPs diet? How have you organized your meals in the challenge phases? One FODMAP containing food per meal? Per day? As far as I can tell it’s a completely individual thing and trial and error with your own digestive system is the only way to determine what you can and can’t tolerate. But I’m curious about how others have been sorting out the tolerable quantities of an item without being completely miserable for the whole testing period. If you have advice, please share.
Very good info
Tried to add a few foods like lactose free yogurt, and also ate oatmeal and some crunch master crackers, and was a mess for a few days 
Went back to protein and cooked veggies to heal. One main problem, became a diet coke addict since I’ve removed sugar from my diet …and I know it’s horrible!! Ahhh! Also, what’s your reasoning for carob chips instead of a vegan chocolate chip? Just curious 
Posted by Ashley | February 4, 2012, 6:12 pmi like carob better than chocolate.
Posted by elise | February 4, 2012, 7:34 pmOk. A few years ago I couldn’t find the carob chips anywhere, so settled on the vegan ones. Did you use Patsy’s elimination diet and challenge? I know you referenced her book.
Also, many lists I come across have a low Fodmap list and high Fodmap list, so how do you know which foods are no Fodmaps?
Posted by Ashley | February 4, 2012, 7:41 pmyeah. her book is the one i used as a guide for the elimination and challenge phases, but it wasnt terribly specific in regards to the exact amount and how often and all that.
to determine if a food has NO fodmaps, you kinda have to know a little about the chemistry of food and your body’s physiological activity, but its definitely something you can learn. obviously fodmaps are only in foods that have carbohydrates since they are by definition fermentable saccharides (short chain sugars). there are books that explain macronutrients and how your gut breaks them down but i’d suggest getting patsy’s book first. its simple, it explains which foods to avoid and which to eat in moderation and which are safe. i also just ordered the monash univ book that i linked to in the resources tab, so ill let you know when i get it what it has. i think its the latest info on which foods have been tested and which are deemed no fodmaps.
Posted by elise | February 4, 2012, 9:36 pmYeah, I had Patsy’s book but I wasn’t overly impressed it with it, and then lent it to someone. I considered ordering a second copy but a lot of her info was outdated anyway, as she has so many updates on her website. The monash univ definitely seems like a better resource, so please let me know if you think it’s worth ordering. I just received Kate Scarlata’s book, and it wasn’t that great in terms of education…really dumbed down, and mainly recipes low in Fodmaps, which could be useful down the line. And she also mentioned having a client who has issues when eatin hummus and apples, was that you?!?! Also, thefartingpear.com has a search engine to search for foods high in fructose, possible fructans too, but some of the info differs from what you read elsewhere. Another worthy site is foodintol
Posted by Ashley | February 5, 2012, 4:55 amSorry! Hit the wrong button on my phone.
Foodintol.com has an elimination and challenge plan that’s 21 days per food your challenging. It’s meant for food intolerances such as lactose and wheat, but can easily be used for the Fodmaps. It’s printable and it is a really good journal to record all symptoms and food eaten. Worth checking out. I understand all the scientific aspects of this, and as you can see, I’ve been researching awhile. Just haven’t gone through with it. Patsy’s elimination diet provided many more foods than I was eating, and it seemed more low and no Fodmaps. So, did you avoid bananas during your no Fodmaps stage?
Posted by Ashley | February 5, 2012, 5:00 ami did have bananas. i made sure they were super ripe though (which wasnt a prob since thats the only way i like them)
those websites are awesome. i just downloaded the foodintol dietary guide so ill look it over. definitely looks helpful. ill keep you up to speed as i go…
thanks for the info
Posted by elise | February 5, 2012, 10:17 amI followed the advice of Monash Uni re: the elimination and challenge phases, which meant 8 weeks (yikes!) on the elimination phase, followed by a very systematic challenge phase. I can’t share the specific details (I think it’s proprietary information?), but it was very specific regarding the order and the amount of food you should eat. For example, the first challenge is fructose and you try 1 tsp of honey three days in a row, record your symptoms. If you react, you wait until the symptoms subside to introduce the next food group. All the portion sizes were super small, and they were all set up that way (i.e. eat a small amount 3 days in a row, see if you react, then move on). After I went through that sequence, I then waited a while for my symptoms to go away and started to increase portion sizes, but only testing out one type of FODMAP at a time. When I tried to stray from this (e.g. mix GOS and fructans, like with a bean burger on a wheat bun), I was in serious pain! Now that I’ve been on the diet for several months, I am starting to be able to relax a little, but it’s still easy to overdo it on some groups, particularly fructans and GOS! I find fructose is easier to avoid, but a plant-based diet can be fairly difficult (especially when I travel for work or research and have to eat out) when it comes to fructans and GOS. Veggie burgers or a veggie sandwich used to be a reliable meal I could order when eating out!
Anyway, back to the challenge phase…I found being VERY systematic definitely did help, as I was able to pinpoint exactly what and how much bothered me. For instance, I found I can eat one of these really thin wholewheat wraps (called ‘mountain bread’), but I can’t eat a sandwich on wheat – it’s too much. I also found that even the 1 tsp of honey killed me. Not that I normally eat honey, but it showed me that I am quite sensitive to fructose!
Posted by saraheclement | February 4, 2012, 6:50 pmis the monash advice in that booklet? i just ordered it, so im now waiting for it to arrive. if not where did you find that specific challenge schedule?
it sounds like a very helpful plan. as annoying as it was, im sure it helped you learn a ton. i will probably end up doing challenge phases again to get even more specific info so if you know where i can get that plan you used from monash, let me know. thanks!
Posted by elise | February 4, 2012, 7:34 pmNo, the advice isn’t in the booklet. It should be, but it’s not! I also don’t think it’s online. Maybe it’s in an effort to get people to seek their services? Anyway, it was given to me by my dietician.
It’s still good to have the booklet. It is SO helpful though just for the food lists. The information on the web is just too conflicting.
Posted by Sarah | February 11, 2012, 4:45 amthanks for the info. my booklet is on the way thanks to kate scarlata.
Posted by elise | February 11, 2012, 5:48 amAww man I really want to do that challenge plan! Gutted it’s not share-able. But awesome it worked for you. I’m going to use the foodintol website I think, to figure everything out.
Posted by Alex | May 23, 2012, 6:40 pmfoodintol is a great place to start.
Posted by elise | May 25, 2012, 12:18 pmOur tasks are the presentation individuals capabilities.
Quite simply a pen. It’s like a printer, hooked directly to my brain.
Posted by Derick Dakes | March 12, 2012, 6:48 am