As a Register Dietitian/Nutritionist, I am noticing a significant increase in the number of patients that I see that are suffering with various gastrointestinal (GI) issues, including irritable bowel syndrome (IBS). IBS is sometimes considered a “catch all” diagnosis that is typically a condition of either chronic diarrhea or fluctuating diarrhea and constipation. Many people with chronic diarrhea are reluctant to leave their homes and/or are not able to eat while out of the house for fear of not being near a bathroom. 

A major reason for the increase in this condition could be the overuse of antibiotics. When I question many of my patients that complain of GI issues, such as gas, bloating, diarrhea or heartburn as to whether they have taken antibiotics, they don’t always remember at first. However, as we talk, they often recollect several instances of antibiotic use in the past year or two or possibly excess use as a child.  

Our GI tract contains approximately three to five pounds of microbes, which is called our microbiota. A healthy microbiota is believed to be made up of at least a thousand different types of microbes of which about 80% are considered beneficial and 20% may be less beneficial. When an antibiotic is taken, it can decrease the diversity of these microbes, causing a condition referred to as “dysbiosis”.  

As you may be aware, antibiotics are now being more carefully prescribed as a lot of new research is showing that the disruption of our microbiota can have harmful effects on many systems in our bodies. This is especially true for our GI tracts. When there is dysbiosis, often a person has trouble with digesting certain carbohydrate foods, which can then lead to gas, bloating, diarrhea, sometimes constipation and heartburn.   

Additionally, medications taken for gastroesophageal reflux (GERD) can also cause dysbiosis as they are decreasing stomach acid. One of the functions of stomach acid is to kill the bacteria that is on the food that we eat. If there is less acid, there is more of a chance of allowing harmful bacterial overgrowth.  

A dietary plan that my patients and I are finding very effective in treating IBS is called the Low FODMAP diet. There have now been many studies done on the Low FODMAP diet, which are demonstrating it to be very effective for most people with IBS.

A Low FODMAP diet is a short-term type of elimination diet in which certain carbohydrate foods are limited for approximately six weeks. FODMAPs are actually an acronym for different types of sugars that are contained in certain carbohydrate foods. Carbohydrate foods are very prevalent in our diets and include all grains, cereals, pasta, fruits, milk products, sweets and even vegetables. However, only carbohydrates that are high in five particular types of sugars, specifically fructose, lactose, fructans, galactans and polyols, are considered a problem with causing these GI symptoms, which typically occur when there is dysbiosis in the intestinal tract. It can then lead to fermentation of these sugars, causing gas and bloating. Additionally, there is increased water pulled into the intestines, which typically causes loose BMs or diarrhea.

The Low FODMAP diet breaks down the carbohydrate food groups into high and low FODMAPs foods. It is recommended that someone choose from the low FODMAP foods as much as possible for up to six weeks. As symptoms hopefully resolve, a slow reintroduction of higher FODMAP foods is done to check for tolerance. Additionally, it is recommended that a patient be on a good probiotic, as well as other foods that contain beneficial bacteria. 

I am always thrilled when I talk with a patient and they tell me that they can’t believe what a difference the Low FODMAP diet has made for them. It really makes my day!

Integrative and Functional Nutrition is located at 53 S. Main St., Ste. 2F, in Medford. For more information or to schedule a consultation with Elizabeth Amisson, call 609-726-1407 or email [email protected].