Gut Issues? Try These Tips Before You Consider the Low FODMAP Diet
Anyone who has gut issues has done their fair share of Googling to figure out what they can do to feel better. You might’ve also visited your doctor for suggestions on how to decrease your symptoms. Most likely, the recommendation you’ve seen online or received from your doctor is to go on the low FODMAP diet. This isn’t necessarily bad advice! Three-quarters of IBS (irritable bowel syndrome) patients who go on the low FODMAP diet see improvement in their symptoms (Nanayakkara et al, 2016).
However, the low FODMAP diet shouldn’t be your first step when making dietary changes to calm your troubled tummy. Though many people do experience benefits from going low FODMAP, it is a very restrictive, complicated diet. To reap its benefits, the low FODMAP diet must be closely followed. This requires great attention to detail, strong organization skills, and the time and ability to plan and cook meals. It’s definitely not impossible, but you need to be prepared to put the work in.
Following the low FODMAP diet requires a lot of work and should not be the first step you take in addressing your gut issues.
More importantly, there are many factors aside from FODMAPs that can trigger gut symptoms. There are foods and patterns of eating that affect our gut that have nothing to do with FODMAPs. If you don’t address the various facets of your gut health and instead just skip to the low FODMAP diet, you might not see much improvement in how you feel because you’re only addressing one piece of the puzzle. In my private practice, I always cover the non-FODMAP factors first with clients who have IBS or other chronic gut issues. Most clients will experience significant improvement in their symptoms just from following my firstline advice alone.
Before you put yourself on the low FODMAP diet, try making more general dietary changes first. They might be all you need to get your gut to chill out. (What are these general dietary changes? I’ll get to those in a moment - be patient!) If your symptoms don’t improve to your satisfaction, that’s the time to give the low FODMAP diet a shot. However, consider visiting a registered dietitian to make sure you know how to properly follow the diet and to get helpful tips to make the lifestyle change easier for you.
An Explanation of Gut Motility
You’ll notice that, in my explanations for many of the tips below, I mention gut motility. What is gut motility? It’s a term used for the movements of the digestive tract. Our intestines have nerves and muscles that coordinate the transit of the things we eat and drink through our gut. When the nerves or muscles in any portion of the digestive tract don’t function as they should, that leads to gut motility problems - or dysmotility. Meaning that things might move too fast through our gut (causing diarrhea, loose stools, or cramping) or too slowly (resulting in constipation or bloating).
Symptoms are often caused by the “traffic” in our gut moving too fast or too slow.
Gut dysmotility is a common root cause of gut issues. Most of the nutrition tidbits in this post provide strategies for regulating gut motility so that what we eat and drink moves through our body at an appropriate pace. Of course, there are other causes of gut symptoms besides dysmotility. Your issues might also be caused by dysbiosis in your microbiota, excess fermentation in your colon, and/or hypersensitivity in the nerves that line your intestines. Each of these causes will be touched upon by the factors below, but for more comprehensive, individualized recommendations, book an appointment with a registered dietitian in your area who specializes in gut issues.
And now, without further ado, here are my non-FODMAP nutrition tips to try out before you go on the low FODMAP diet.
Eat at regular intervals throughout the day
eating at regular intervals throughout the day will help to regulate gut motility. This means eating 3 meals and at least 1 snack each day.
if you tend to forget to eat, make a schedule for when your meal and snack times will happen. Be sure to eat something within 2-3 hours of waking up and then after your first meal, eat every 3-4 hours.
eating regularly also prevents overeating. Eating large amounts of food in one sitting can aggravate your symptoms.
additionally, eating enough during the day decreases nighttime eating. Eating less than 2 hours before bedtime can cause your symptoms to flare up and prevent a good night’s sleep.
try not to skip meals. If you’ve got a busy day coming up and won’t be able to stop for a full meal, plan ahead. You can eat a lighter meal a bit earlier than your usual mealtime. Or have a couple of filling snacks with you that you can eat during 5-10 minute breaks.
Take your time while you eat
thoroughly chew your food. This aids the digestion process. Your food should be the consistency of baby food (ie: pureed) before you swallow it.
rushing through your meal might get you feeling stressed out, and stress can upset your gut.
if you have a super busy schedule, make sure you eat at least one meal per day at a relaxed pace. It’s important to prioritize your health!
Hydration
drinking water helps to regulate gut motility and is soothing when you’re experiencing discomfort in your gut.
aim to drink 2 - 3 liters of fluid per day, depending on your activity level. For an easy rule of thumb, if your urine is pale yellow, you’re properly hydrated.
sources of hydration include water, milk & milk alternatives, herbal teas, and broth.
Food items that tend to cause symptom flare-ups
**Everyone’s tolerance to these food items varies. For each item on the list, you might need to limit it, avoid it entirely - or it might not be problematic for you.**
alcohol: causes irritation and speeds up gut motility. Drink no more than 2 servings per day and have at least 2 alcohol-free days per week.
caffeine: speeds up gut motility and may cause cramping. Drink no more than 2 cups of coffee per day. Depending on your tolerance, you might need to reduce your intake further. Be aware that other sources of caffeine include black tea, energy drinks, pop, and chocolate.
(Note: for people with constipation, a moderate amount of caffeine might help improve your symptoms).
carbonated drinks: pop, carbonated water, etc. The gas added to these drinks worsens gas and bloating. If this is a trigger for you, have still water instead. You can introduce some flavour by adding fresh mint, ginger, cucumber slices, frozen berries, lemon or lime juice, etc.
spicy foods: capsaicin - the molecule that gives hot peppers their “heat” - increases gut motility, which worsens diarrhea. And it can cause abdominal pain. If spicy foods are a trigger for you, try turning down the heat level and eating a smaller portion. Be sure to eat a balanced meal when you eat spicy food that includes lean protein and produce.
high-fat foods: can trigger gas, pain, and worsens both constipation and diarrhea. Examples include: fried foods (ie: anything battered), pizza, burgers, fries, chips, ribs, creamy sauces. Try eating these foods less frequently, having a smaller portion size, and/or include sources of protein and fibre in your meal.
sources of concentrated simple sugars: juice, energy drinks, pop, candy, etc. Concentrated sugars can make bloating, gas, and diarrhea worse. However, they might be better tolerated when consumed alongside other foods containing protein, fat, and fibre. Sugary beverages might be better tolerated when watered down.
Take a probiotic
A healthy microbiota is very diverse and the types of good bacteria outnumber the bad bacteria. In people with IBS or other gut issues, they tend to have a microbiota that is lacking in diversity and contains more bad than good bacteria. Taking a probiotic will help make your microbiota more diverse and increase your number of good bacteria.
research shows that liquid probiotics are more effective than solids. I recommend a kefir called The Cultured Coconut. It can be found in Ontario at Goodness Me, Zehrs, various health food stores, and on the company website
if possible, take your probiotic first thing in the morning on a fasted stomach with cool to lukewarm water.
if you’re taking your probiotic with food, be sure that food is not hot or acidic. This will kill the bacteria, making them ineffective.
start slowly with the dose. Take 1 teaspoon per day for about a week. Then progress to 2 teaspoons per day for another week. Finally, take the full tablespoon.
Tips for bloating and gas
limit gassy foods: beans, lentils, Brussels sprouts, cauliflower, sugar-free candies (ex: mints, gum).
eat sources of soluble fiber: oats, flaxseeds, chia seeds, ground psyllium husk, citrus fruits, bananas, apple sauce, carrots, white rice, etc.
Tips for constipation
add fibre to your diet: vegetables, fruits, seeds (flax, chia, hemp hearts), whole grains (oats, brown rice, quinoa), potatoes with the skin on.
boost the fibre in your meals: add 1 tablespoon of whole or ground flax seeds, chia seeds, or psyllium husk to hot cereal, cold cereal, yogurt, soup, salads, sauces, etc.
**Be sure to increase your fibre intake slowly:
add one serving of fiber at a time and give yourself several days to adjust.
if you do not currently consume seeds or psyllium husk, start with just ½ teaspoon and very slowly make your way up to 1 tablespoon
drink lots of water. For each added serving of fiber, drink an additional ½ cup of fluid.
*Note that moderate-intensity physical activity is also an important strategy for improving constipation
Tips for diarrhea
drink extra water to replace fluids lost through diarrhea.
limit yourself to 3 caffeinated beverages per day (ie: coffee, tea, pop, energy drinks).
decrease the amount of high fiber foods you’re eating (ie: raw fruits and vegetables, whole grains, legumes). Fibre makes things move through your gut faster, making diarrhea and loose stools worse.
avoid sugar-free items that contain sugar alcohols like sorbitol, mannitol, and xylitol.
Make one change at a time!!
PLEASE do not try to make all of these changes at once. That would just be overwhelming and stressful. Pick one modification you want to start with and give yourself a few weeks to get the hang of it. Once it becomes easy, add one more change to your diet. With some patience, you’ll gradually be able to address all the factors explained in this post - and hopefully see positive changes in your gut health!
What’s the first goal that you’re going to set?
References
British Dietetic Association. (2021). Irritable Bowel Syndrome and Diet: Food Fact Sheet. The Association of UK Dietitians. Accessed April 28, 2021. https://www.bda.uk.com/resource/irritable-bowel-syndrome-diet.html
Nanayakkara, W. et al. (2016). “Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date.” Clinical and experimental gastroenterology vol. 9 131-42. 17 doi:10.2147/CEG.S86798