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You may have heard some ‘bad’ things about fructose in the media in recent years. Fructose is a simple sugar molecule and the reason that it has received so much bad press, is probably on the back of the ‘sugar is white death’ movement. If you happen to find a product with ‘high fructose corn syrup’ in the ingredients, you can be sure this is a high sugar product - and for that reason, best to leave on the shelf. Note, it’s not the fructose that is the problem, but the high concentration manufacturers use to achieve the intense sweetness high fructose corn syrup gives. For people with IBS, fructose can present a problem when it is in excess of a fellow simple sugar molecule - glucose. When you’re digesting more fructose than glucose, your gut absorbs it less efficiently. We call this ‘excess fructose’. In high doses, excess fructose may not be absorbed properly and can lead to IBS discomfort. Most people are able to absorb fructose without any issues, but around 30-40% of all people are unable to absorb excess fructose.

Lactose is a disaccharide sugar (two sugar units joined together). In order for lactose to be absorbed, ‘lactase’ enzymes on the wall of your small intestines break it into two single sugar units. Some people lack the enzyme lactase and therefore are unable to absorb lactose well. This is called lactose intolerance, and for sufferers it can cause gastrointestinal discomfort.

Oligosaccharides are sugar molecules with between 3 and 10 single sugar units joined together. They are made up of fructans (also known as FOS, fructo-oligosaccharides - they are short chains of fructose) and galacto-oligosaccarides (also known as GOS - they are short chains of galactose molecules). Digestion of these in the large intestine involves fermentation by bacteria and by-products of carbon dioxide and hydrogen. People with IBS have an extra sensitive gut – so this gas production can trigger uncomfortable symptoms of pain, bloating and wind (flatulence).

Polyols can present digestion issues for many people as they are not completely absorbed in the small intestine. Two of the most common, sorbitol and mannitol are often used as artificial sweeteners and so if you have IBS, it is best to limit foods with these featured in the ingredients.

IBS is a common condition in where your bowels struggle to properly digest some food items. The undigested food particles ferment in the large bowel and can create excess wind, pain, bloating and changeable bowel habits. Most people find their condition is worse during times of stress and can be managed by making some lifestyle changes, as well as of course; the Low FODMAP diet. The most common symptoms of IBS are: Pain or discomfort in your stomach Bloating in your stomach Diarrhea (the runs) or constipation (hard poo), or sometimes both Passing mucus with your poo Too much wind (flatulence or farting) These symptoms can be enhanced with stress or certain foods may trigger a symptom. Check out HealthInfo Canterbury for further information if you are interested here.

The answer to this question is still largely unknown! A diagnosis of IBS can initiate a journey into self discovery. Some people will notice a great improvement in symptoms after simply sitting down to eat their food, chewing their food properly and not eating too much in one sitting. Others, find no relief this way. What we do know is that people with IBS appear to have a hypersensitive gut and difficulties with FODMAP digestion, hence why treatment focuses on mindful eating and the Low FODMAP diet.

The initial phase of the Low FODMAP diet is 4 weeks. Over this time you reduce foods in your diet that contain FODMAPs. After 4 weeks, you will know if the Low FODMAP diet has worked for you. If you are feeling much better, you can start the 'reintroduction phase' of the diet. During this phase you continue to adhere to the Low FODMAP diet, whilst strategically challenging your tolerance levels with specific high FODMAP foods. There are 3 parts to the Low FODMAP journey. Part One - Introduction class - this is where you learn how to do the diet for 4 weeks Part Two - If you have improvement, you attend this class next, this part takes 8 weeks Part Three - Managing your IBS with your new found knowledge. At Village Health, we run classes to cover Part One and Two of the diet. You will leave with the skills you need to manage Part Three. Please note: The Low FODMAP diet should not be followed in times of stress, and is not recommended when you have any major social events or a holiday!

Finding reliable and researched-based information is vital for Low FODMAP education. We can recommend the below sites for further information: Monash University HealthInfo A Little Bit Yummy Healthy Food Guide Just click on the links above to access these sites. Please note that Healthy Food Guide will give you free access to a few blogs - after this you will need to subscribe for a small fee.

There is a strong link between our gut and brain, which can have a huge impact on all types of gut health. Consider your sleep pattern, stress management, and general life enjoyment. For some people, meditation and yoga can really help with managing IBS symptoms. Increasing your exercise gradually may also help reduce IBS symptoms. Other things to consider are slowing down your speed of eating, sitting down while your eating, and eating with no distractions (with no phone or TV). 30% of digestion occurs in our mouth with the help of digestive enzymes in our saliva - so the more you can help out your gut by chewing your food well, the better!

No, but eating gluten-free foods can sometimes help people manage their IBS symptoms - but this is not due to the gluten! Gluten is a plant protein found in wheat, barley, rye and oats. Fructans are a type of FODMAP that are found in a variety of foods - of which includes wheat, barley, and rye (all of which the plant protein gluten is in). Therefore, to avoid these FODMAP foods, gluten free options like breads and pastas can be the easiest option for some. However please be aware - gluten free foods can still contain other FODMAP components, always check the label.

No. If someone with IBS eats certain FODMAP foods, this can result in various gut symptoms that are uncomfortable and at times debilitating (i.e. bloating, wind, constipation, diarrhea), but this will not physically harm the person. If you are ever concerned about your symptoms, get in contact with your GP.

If you have followed the Low FODMAP diet strictly and have not noticed a significant improvement in your symptoms, it is important that you go back to eating normally and return to your GP. You may require further testing, or a one on one consultation with a dietitian or other specialist to investigate your ongoing symptoms.

Using your ‘FODMAP Reintroduction Diary’, you will now have a much better understanding of which FODMAP food groups you can tolerate and in what quantities (i.e. small - large serves of foods). It is not recommended to stay on a Low FODMAP diet long-term, as it is low in fibre and very restrictive. After the reintroduction phase, some will find they can go back to a totally liberalised diet, eating both high and low FODMAP foods. Some however, will find they need to revisit the Low FODMAP diet for a few days at a time if their symptoms become severe again. Over time, you will work out which foods are your 'friends' and which foods - you can only tolerate in small doses.