La diète faible en FODMAP pour le Syndrome de l'Intestin Irritable (SII ou SCI)

The low FODMAP diet is not a weight loss diet. It is a nutritional treatment that can be used to reduce the symptoms of irritable bowel syndrome (IBS). As early as 2005, an Australian nutritionist developed this diet, which significantly reduces the digestive discomfort experienced by people with IBS. The word FODMAP is an acronym that stands for the four groups of fermentable carbohydrates.

So, as promised in the article:Celiac disease, Gluten intolerance or Irritable bowel syndrome? , here is the description of this acronym:

F for Fermentable

Fermentable carbohydrates are small carbohydrates that are poorly absorbed by the small intestine and quickly fermented by bacteria in the large intestine. These carbohydrates may have a role in triggering symptoms of IBS. In fact, in individuals with IBS, the consumption of these carbohydrates leads to a significant inflow of water into the intestine and an increased production of gas during fermentation, causing intestinal distension (expansion of the intestines, often expressed as a feeling bloated, or "looking a few months pregnant"). Then, in combination with factors such as visceral hypersensitivity (pathology where there is pain felt during distension of the digestive tract), stress and anxiety, symptoms of IBS can be triggered (eg: abdominal pain , bloating, gas, diarrhea and / or constipation).

These carbohydrates include oligosaccharides, disaccharides, monosaccharides, and fermentable polyols.

O for Oligosaccharides

Oligosaccharides are the fructose - mainly the fructans , the inulin and the levans - and the galactooligosaccharides (GOS) . Fructans are carbohydrates found in particular in wheat (e.g. bread, pasta), barley, rye, onions and ai, etc. They are also found in asparagus, cabbage, beets, leeks, etc.

GOS are carbohydrates that are found, among others, in legumes (eg: lentils, chickpeas, kidney beans, etc.) and artichokes, etc.

D for disaccharides

The disaccarides designate a sugar composed of two small sugars. They mainly concern the following sugars: sucrose (combination of glucose and fructose), maltose (combination of two glucose) and lactose (combination of glucose and galactose).
The most problematic disaccharide is lactose, a carbohydrate found in dairy products such as milk, cream, ice cream, yogurt, and cheese.

M for monosaccharides

Monosaccharides include fructose, a carbohydrate found in certain foods, such as honey, vegetables, and fruits. For example, apples, dates, raisins, contain a lot of fructose.

A for and / and

P for polyols

Polyols are carbohydrates that contain "alcohol" groups. There are several types of polyols. They include, sorbitol and mannitol, carbohydrates that are found naturally in certain fruits and vegetables, such as apples, apricots, dates, prunes, pears, peaches, cauliflower, mushrooms, etc. .

We also find them in their synthetic form, as additives or artificial sweeteners in certain sweets (eg: sugar-free candies, non-naturally sweet chocolates, sugar-free chewing gum, sugar-free ice cream, etc.).

FODMAP nutritional approach

Now that we have demystified the acronym, let's take a look at what the low FODMAP diet is all about. This diet is divided into three phases: the low FODMAP diet, the reintroduction and personalization of the low FODMAP diet.

Phase 1 Low diet in FODMAPP

This first phase lasts from 2 to 6 weeks. During this phase, all foods high in FODMAP are replaced by foods low in FODMAP, for each of the four groups.

Phase 2 Reintroduction of FODMAPsP

The second phase lasts 6 to 8 weeks. During this phase, foods from each group are reintroduced into the diet according to a reintroduction protocol or plan. The reintroduction is done gradually, one group at a time, and with only a few foods per group, usually one or two. The protocol presents a list of foods to be reintroduced for each group of carbohydrates as well as the quantity and frequency of consumption. The amount and frequency of consumption is important, as there may be a cumulative effect and the sensitivity to a group of carbohydrates may vary over time. The protocol also specifies an order for the reintroduction of groups, which may vary between individuals. This phase helps identify which groups and / or foods trigger symptoms.

Phase 3 Personalization of the low FODMAP dietP

During the third phase, the results of the second phase are interpreted and the diet is personalized according to the tolerance and sensitivity of each individual. Foods are reintroduced based on symptoms and only the foods and groups that trigger them are restricted. In general, it is unlikely that a group of carbohydrates should be omitted altogether.

Conclusion

The low FODMAP diet is a nutritional approach that can be used in individuals with IBS. However, as we have seen, this is not a diet that must be adopted for life. The low FODMAP diet is only the first phase of the nutritional approach, then it is important to reintroduce foods and customize the diet according to the specific needs of each individual. To do this, do not hesitate to consult a dietitian, who can assist you in this process.

 

References

 

Bouthillier, Lise. January 2019. Diseases of the digestive tract. NUT 2047 Clinical nutrition 2. Montreal: University of Montreal.l. 

Nahikian, M. (2016). Nutrition Therapy for Irritable Bowel Syndrome.Nutrition Therapy and Pathophysiology, Cengage Learning, pp. 415418..

https://www.merckmanuals.com/fr-ca/accueil/troubles-digestifs/syndrome-de-l-intestin-irritable-sii/syndrome-de-l-intestin-irritable-siiquery=Syndrome%20de%20l% 27intestine% 20irritablee

  

 

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