Irritable bowel syndrome (IBS) is a fairly common ailment among people with diabetes. More than 50 percent of people with diabetes complain of some type of gastrointestinal symptoms. IBS isn’t dangerous, but it is often difficult to control and its symptoms can be life altering. Severe IBS may limit your ability to engage in regular socializing. Never knowing if/when you may need to run to a bathroom can put a real damper on your social life.
Since diabetes can affect the organs of the gastrointestinal tract, people with diabetes can be troubled by IBS. Lifestyle measures to treat IBS include an increase in fiber, a decrease in fat content in the diet and the use of stress reduction techniques.
In the last few years a new dietary treatment called FODMAPs has come to the forefront. FODMAPs is a strange sounding word. Actually it is an acronym for the following: fermentable carbohydrates oligosaccharides, disaccharides, monosaccharide, and polyols . These are sugars that some people have difficulty digesting. People who cannot tolerate the foods containing FODMAPs may experience diarrhea, gas, bloating, constipation and the abdominal discomfort common in IBS.
Clinical studies have shown that in a majority of people, following a plan that significantly reduces the amount of FODMAPs in the diet has been effective in reducing gastrointestinal symptoms . The diet isn’t easy, but with the help of a dietitian familiar with the guidelines you can eat a nutritionally balanced meal plan that takes into account your food preferences and your diabetes control.
Below are some of the foods containing FODMAPs which should be limited if you have IBS.
- Free Fructose: apples, pears, mango, watermelon, fruit juice, sugar snap peas, honey, high fructose corn syrup
- Lactose: milk (goat, cow, sheep), yogurt, ice cream, soft cheeses (ricotta, cottage) (many additional foods such as pancakes contain lactose) Tolerance to lactose varies by individual.
- Polyols:apples, apricots, cherries, lychee, nectarine, pears, peaches, plums, prunes, watermelon, avocado, cauliflower, mushrooms, snow peas.
- artificial sweeteners: sorbitol, mannitol, xylitol, maltitol, isomalt
- Fructans: wheat, rye, onions, garlic, artichokes, bananas, peaches, watermelon, legumes, lentils, chickpeas.
- Galactans: legumes-soy, chickpeas, lentils, red kidney beans, baked beans.
Before starting the diet you may want to have a breath test for malabsorption of fructose, lactose and sorbitol. When sugars are poorly digested, the bacteria in the colon metabolize them, releasing hydrogen atoms into the blood which are eliminated into the air upon exhalation. If the tests are positive, a 6-8 week trial of the diet is in order. Be sure to work with your dietitian and healthcare provider to find the diet plan that will work best for you.
Following the diet to the letter at the beginning will make it easier to add foods back in gradually to see if you can tolerate them. The FODMAPs diet doesn’t work for everyone and it can be difficult to navigate, but it is worth a try. Otherwise living life always looking for the closest bathroom isn’t much fun.
To get more advice on healthy eating, make an appointment with a Joslin Dietitian!