We get a lot of children and adults coming into Lemond Nutrition with chronic bloating and stomach pain. They have gone to a gastroenterologist and all tests come back normal. No evidence of celiac disease, inflammation or infection. There is also no evidence at all of anatomical abnormalities. Is it something they are eating – or not eating - that could be causing these symptoms? Many patients come to us feeling desperate for relief and a desire for validation despite the normal test results. If this is you or one of your family members – you are not alone.
Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is one of those seemingly vague diagnoses that a person gets when all tests come back normal yet symptoms persist. IBS can be complicated with bouts of constipation, diarrhea or even a cycle back and forth between one or the other. IBS seems to be exacerbated by stress, so regardless of what you eat, the exposure to life’s pressures certainly affect the GI tract in those with IBS. Historically, dietitians treated IBS with a high fiber diet, maximize fluids and general reduction of foods that are known to cause excessive gas. Some people find a reduction in symptoms with this nutrition prescription, while others continue to have problems.
Non-Celiac Gluten Sensitivity?
Some people have seen a significant reduction of their symptoms when they eliminate gluten from their diet, and they find that there is a condition many healthcare professionals call non-celiac gluten sensitivity (NCGS). While taking gluten out of your diet relieves some symptoms, you may find that not all recurring gas and bloating has subsided. Now what?
It may not be the protein (gluten) in the food, it just may be the carbohydrate. In other words, foods high in gluten are also high in these types of carbohydrates that promote fermentation and gas production. So yes, eliminating foods that contain gluten help because of the reduction in those specific carbohydrates – but that does not eliminate all the offending foods.
FODMAPs = Fermentable Oligo-Di-Monosaccharides & Polyols
Fermentable Oligo-Di-Monosaccharides & Polyols – say that three times – fast! OK, well then just say FODMAPs. These types of carbohydrates draw fluid into the intestinal tract and cause fermentation when eaten in excess. Those foods are foods that are high in:
- Fructose: certain fruits and honey
- Lactose: milk sugar found in milk and dairy products
- Fructans: wheat, onion, garlic, inulin
- Galactans: legumes (including soy), beans, lentils
- Polyols: sugar alcohols such as mannitol, sorbitol, xylitol; certain fruits such as avocado, peaches, cherries, plums.
Try a Low-FODMAP Diet
If you have tried other nutrition treatments and have had no success for your stomach pain, gas and/or bloating you might want to try a low-FODMAP diet. The diet originated out of MONASH University in Australia, and their website is chocked full of information about following a low-FODMAP diet. The idea is to try it fully for 2-6 weeks and then add back foods one at a time. The diet was not designed to eliminate everything high in FODMAPs. It was specifically designed to determine what specific high FODMAP foods your body specifically reacts to and keep those minimized or eliminated from your diet. Many times with FODMAPs, the danger is in the dose. Your body may tolerate a certain amount of something that has high FODMAPs if you were to eat it in a single serving, but any more may cause problems. Here is a 3-day low-FODMAP plan for you to sample. Customize serving sizes for your specific energy requirements:
- 1 cup (C) lactose-free milk
- 100% wheat-free bread
- 2 tablespoons (Tbsp) all-natural peanut butter
- One medium banana
- Brown rice
- Chicken (cooked)
- Cooked carrots, zucchini
- Sunflower seeds
- Honeydew melon
- Salmon (cooked)
- Spinach, tomato, and cucumber with oil and vinegar dressing
- Cooked quinoa
- Wheat-free crackers and cheddar cheese
- 1 C lactose-free milk
- Wheat-free cereal (cannot contain honey, apple juice, pear juice, agave, or high-fructose corn syrup)
- Lactose-free yogurt
- Cantaloupe and honeydew
- Wheat-free rice cakes
- Pork loin or center-cut pork chop (cooked)
- Lettuce, cucumber, and tomato salad with oil and vinegar dressing
- Strawberry sorbet
- Hard-boiled eggs
- Wheat-free oats
- 1 C lactose-free milk
- Pineapple spears
- Sandwich made with wheat-free bread (cannot contain honey, apple juice, pear juice, agave, or high-fructose corn syrup), sliced turkey, Swiss cheese
- Mandarin oranges
- Wheat-free animal crackers
- Corn taco shells or tortillas
- Fresh ground beef (cooked), seasoned with chili powder, crushed red pepper flakes, ground cumin, and/or black pepper
- Strawberries dipped in semisweet chocolate
- Wheat-free pretzels
Banana Flax Smoothie
½ cup lactose-free skim milk
½ cup plain Greek yogurt
1 ½ T ground flax seeds
1 very ripe medium banana
½ fresh squeezed orange juice
4 ice cubes
Combine all ingredients in a blender set to the smoothie setting. Mix well.
Nutritional Information: calories 295, fat 2.9g, saturated Fat 0.4g, cholesterol 7mg, sodium 119 mg, carbohydrates 53.5g, sugar 34.4g, fiber 6.1g, protein 19.8g.
Before eliminating foods from your or your child’s diet for any length of time, we do recommend that you seek advice from a registered dietitian nutritionist (RDN) so they can make sure the diet is nutritionally appropriate. At Lemond Nutrition, we are happy to help you with a low-FODMAP diet. If you live outside of the Dallas area, you can do a search for someone in your area by going to the Academy of Nutrition and Dietetics website.
A low-FODMAP diet may not be the miracle, but it may certainly reduce excessive symptoms. Be sure to do other things that help digestion, too! That includes better stress management, optimal exercise and adequate sleep.