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High FODMAP Foods & Other Irritable Bowel Syndrome Trigger Foods

Last updated on Oct 29th, 2016 Authored by Alana Scott     Reviewed by Joanna Baker (APD)

Irritable Bowel Syndrome Trigger Foods

Identifying Irritable Bowel Syndrome trigger foods is an important step in learning to manage your symptoms. The low FODMAP diet has been scientifically proven to significantly reduce IBS symptoms in up to 76% of IBS sufferers (1). Therefore, the low FODMAP diet is often the first elimination diet doctors, dietitians, and gastroenterologists will put you on in order to identify trigger foods. However, some low FODMAP foods may contain other common IBS triggers that need to be considered to gain good symptom control. These other common IBS triggers include fatty or fried food, caffeine, alcohol, carbonated drinks, insoluble fibre, resistant starches, spicy foods, or even other food intolerances (2 3). If you are having ongoing symptoms you may like to explore these with your dietitian, and determine if it is beneficial to remove them from your diet along with the high FODMAP foods to identify if they are additional triggers.

High FODMAP Foods

The low FODMAP diet removes a large group of dietary sugars (short chain carbohydrates). These sugars can be poorly absorbed in the small intestine, draw fluid into the bowel, and are fermented in the large intestine by bacteria which produces gas (hydrogen and methane) and contributes to other IBS symptoms (2 4). FODMAP is an acronym that stands for:

Fermentable The process through which gut bacteria degrade undigested carbohydrate to produce gases (hydrogen, methane and carbon dioxide) (5 6).
Oligo-saccharides Fructo-oligosaccharides (FOS) found in; wheat, rye, onions and garlic, as well as many other fruit and vegetables.
Galacto-oligosaccharides (GOS) found in; legumes/pulses (5 6)
Disaccharides Lactose found in; milk, soft cheese, yoghurts (5).
Mono-saccharides Fructose (in excess of glucose) found in honey, apples, high fructose corn syrups and other foods (Source: 5).
(And) Polyols Sugar polyols (eg. sorbitol, mannitol,  xylitol, maltitol) found in some fruit and vegetables and used as artificial sweeteners (5 6)

For a full list of high FODMAP foods we recommend you get the Monash University Low FODMAP smartphone app.

The low FODMAP diet is a specialised area of nutrition, which means, if possible, it is important for you to seek help from a FODMAP trained dietitian (4 6). The dietitian will ensure that your diet remains balanced and nutritionally adequate, as well as help you test and reintroduce FODMAP foods after a trial period. If for some reason you cannot seek help from a FODMAP trained dietitian, speak to your doctor before starting the diet.

Other Dietary Triggers

High Fat or Fried Foods

Fried and fatty foods are difficult to digest and can contribute towards diarrhoea, constipation, bloating and gas (3 7). When you consume fatty or fried foods it can affect gut motility and stimulate contractions in the digestive tract (8). This means it can slow down the emptying of the stomach and worsen constipation, or it can speed up the movement of undigested food through your intestines and cause diarrhoea (8).

Therefore, reducing the consumption of chips, sausages, fast foods, high fat meats, pies, cheese, creamy sauces, cakes, crisps, biscuits, chocolate, mayonnaise, and full fat dairy products (ice cream, yoghurt, full fat milk) may be beneficial (7).

Try to eat lean cuts meat like skinless chicken, lamb loin chops, or fish, as well as cooking meals by grilling, steaming, poaching or dry roasting to reduce added fat (7). Reducing saturated fat is also recommended for heart health.

Alcohol

Alcohol is a gut irritant and can make IBS symptoms worse (3 8). Alcohol can cause your stomach to produce more acid than usual, which can cause gastritis, stomach pain, vomiting, and diarrhoea (9). Limiting your alcohol consumption is beneficial for overall health and wellbeing.

If you do decide you want to have an alcoholic beverage make sure you have no more than two standards units in one day (3 7). Have your alcoholic beverage with food and have at least two alcohol free days per week.

Number of Standard Units in Alcoholic Beverages

330ml bottle of beer (5% alcohol) 1.3 units
175ml glass of wine (12 to 13% alcohol) 2 units
25ml measure of spirits (40% alcohol) 1 unit

(Sourced from Alcohol NZ, 2015; Great Western Hospitals: NHS, 2012)

Caffeine

Caffeine can worsen IBS symptoms because it stimulates the gastrointestinal tract motility, which means food is moved through your digestive system quicker and can cause diarrhoea (8). The National Institute of Health and Care Excellence (NICE) IBS management guidelines recommend reducing caffeinated drinks to 3 cups per day (3). Remember that caffeine isn’t just found in coffee, it is also found in tea, cola, chocolate, and energy drinks (3 8). Bear in mind that switching to decaf coffee may not be enough as it still contains low levels of caffeine (8).

Carbonated Drinks

NICE guidelines also recommend reducing your consumption of carbonated drinks (3). This might be because carbonated drinks often contain other trigger food ingredients like caffeine, high fructose corn syrup, or sugar alcohols, which can cause IBS symptoms. According to accredited practising dietitian, Joanna Baker, the bubbles in the carbonated drinks can also cause issues, as this gas often ends up in the gut contributing to bloating. So if you decide to have a carbonated drink choose a flavour with low FODMAP ingredients and limit your serving size.

Insoluble Fibre

Insoluble fibre is found in the skins of vegetables and fruit, nuts and seeds, brown rice and the bran portion of whole grains (3). Insoluble fibre acts as a ‘bulking agent’ for our stools, which when combined with soluble fibre, helps keep us regular (11 12). However, research indicates that many IBS patients do not tolerate insoluble fibre (like bran), and that increasing the insoluble fibre in their diets could worsen IBS symptoms (13 14 15). This means that if you need to increase fibre in your diet it is better to try to eat foods that are high in soluble fibre. Find out more by checking out our article on soluble and insoluble fibre.

Resistant Starches

Resistant starch is starch “that resists digestion in the small intestine and reaches the colon intact” (3). This type of starch behaves like a type of functional fibre (soluble fibre) that acts like a prebiotic and provides food for our gut bacteria (16). This means once the resistant starch reaches the large intestine it will be fermented by the gut bacteria which could contribute towards IBS symptoms.

Resistant starch is formed when starch containing foods are cooked and cooled, like legumes, cereals (oats), potatoes, bread, rice or pasta (7 17). This means some processed or re-cooked foods could aggravate IBS symptoms (3 7). It is the resistant starch (amylopectin) and soluble fibre in rice and oatmeal that give them their sticky texture (11 16). It is important to note that oats and rice are generally well tolerated unless they are reheated.

Resistant starch can also be found in some fruit and vegetables like green bananas and uncooked potato (17).

Are you ready to take control of your gut symptoms?

YES I WANT TOO!

No thanks, my gut is perfect.

 Spicy Foods

Spicy foods can also trigger IBS symptoms in some people (2 18). Chilli and capsicums (peppers) contain capsaicin, which can cause heat or burning sensations. Other spices are high in the natural chemical salicylates (19). Theses salicylates can also trigger gastrointestinal symptoms in some individuals (19). It is also important to note that spicy foods often contain onion and garlic, which are high FODMAP foods that can also contribute towards IBS symptoms.

Non FODMAP Food Intolerances

If you are not experiencing good symptom relief on the low FODMAP diet, then other food intolerances should be explored with the help of a dietitian. Many low FODMAP foods are high in naturally occurring food chemicals like salicylates, amines, glutamates (Swain, Soutter & Loblay, 2011). These food chemical sensitivities can cause hives, headaches, stomach and/or bowel problems (Swain, Soutter & Loblay, 2011). Soy and milk protein intolerances are also worth exploring.

Final Thoughts

Identifying trigger foods is a complicated process and it is important that you do it in a controlled way so you can retest each food and get a clear reaction. The best way to do this is with the guidance of a trained dietitian who has specialised in FODMAPs and IBS dietary management. Good luck and we hope you find some answers soon. For regular low FODMAP articles and recipes follow us on Facebook.

Author: Alana Scott

In 2013, Alana was diagnosed with Irritable Bowel Syndrome. She also suffers from coeliac disease, is allergic to nuts and is intolerant to dairy products. This means she understands how difficult it can be to cook with multiple food intolerances. Her exp... Read More

Professional Reviewer: Joanna Baker (APD)

Joanna is a foodie, an accredited practising dietitian and a registered nurse, who is passionate about digestive health. She now works exclusively in IBS and food intolerance in her Melbourne based private practice Everyday Nutrition. Joanna works alon... Read More

SHOW REFERENCES

1. Kings College London. FODMAPs . Kings College London. 2015. Retrieved from:http://www.kcl.ac.uk/lsm/research/divisions/dns/projects/fodmaps/index.aspx. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z7Fykdnn)

2. BPACnz. Irritable bowel syndrome in adults: Not just a gut feeling. Best Practice Journal. 2014: Issue 58. 14-25. Retrieved from http://www.bpac.org.nz/BPJ/2014/February/ibs.aspx

3. NICE. Irritable bowel syndrome in adults: diagnosis and management of irritable bowel syndrome in primary care. National Institute for Health and Care Excellence. 2015. Retrieved from:http://www.nice.org.uk/guidance/cg61/chapter/1-recommendations. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z6RJ49TK)

4. Monash University. What happens when FODMAPs are malabsorbed?. Monash University. 2015a. Retrieved from:http://www.med.monash.edu/cecs/gastro/fodmap/mal-absorption.html. Accessed on: 2015-03-06. (Archived by WebCite® at http://www.webcitation.org/6Wq4IpSL9)

5. Monash University. What does low FODMAP stand for?. Monash University. 2015b. Retrieved from:http://www.med.monash.edu/cecs/gastro/fodmap/description.html. Accessed: 2015-03-06. (Archived by WebCite® at http://www.webcitation.org/6WqGyd2fV)

6. Mansueto, P., Seidita, A., D’Alcamo, A., Carroccio, A. Role of FODMAPs in Patients with Irritable Bowel Syndrome: A Review. Nutrition in Clincial Practice Journal. 2015-02-18. DOI: 10.1177/0884533615569886. Retrieved from http://ncp.sagepub.com/content/early/2015/02/17/0884533615569886

7. Great Western Hospitals: NHS. Irritable Bowel Syndrome Self Help Guide. NHS Foundation Trust. 2012. Retrieved from:http://www.gwh.nhs.uk/media/140791/ibs_self_help_diet_sheet.pdf. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z6RdxtLz)

8. Bahls C. 11 Foods to Avoid When You’re Having Digestive Problems. Everyday Health. 2013-08-27. Retrieved from:http://www.everydayhealth.com/digestion-photos/foods-to-avoid-during-digestive-problems.aspx#01. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z6SCXLrK)

9. Drink Aware. Is alcohol harming your stomach?. Drinkaware.co.uk. 2015. Retrieved from: https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/effects-on-the-body/is-alcohol-harming-your-stomach. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z6SfMR9y)

10. Alcohol NZ. Standard Drinks Chart. Alcohol NZ. 2015. Retrieved from:http://www.alcohol.org.nz/sites/default/files/useruploads/Alcohol_YouPDFs/Standard%20Drinks%20Chart.pdf. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z6QdqXM2)

11. Dietitians of Canada. Healthy Eating Guidelines for Increasing Your Fibre Intake. Dietitians of Canada. 2012-10-02. Retrieved from:http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Fibre/Increasing-Your-Fibre-Intake.aspx. Retrieved on: 2015-03-23. (Archived by WebCite® at http://www.webcitation.org/6XEqNur0y)

12. NZ Nutrition Foundation. Fibre. NZ Nutrition Foundation. 2015-03-23. Retrieved from:http://www.nutritionfoundation.org.nz/nutrition-facts/Nutrients/carbohydrates/fibre. Retrieved on: 2015-03-23. (Archived by WebCite® at http://www.webcitation.org/6XFZwebWD)

13. Bijkerk, C., Wit, N., Muris, J., Whorwell, P., Knottnerus, J., Hoes, A. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. British Medical Journal. 2009: Volume 339: Issue 7721. 613-615. DOI: 10.1136/bmj.b315 Retrieved from http://www.bmj.com/content/339/bmj.b3154.abstract Retrieved on 2015-03-24.

14. Francis, C. & Whorwell P. Bran and irritable bowel syndrome: Time for a reappraisal. The Lancet. 1994: Volume 334. 39-40. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7912305

15. Ford, A., Moayyedi, P., Lacey, B., Lembo, A., Saito Y., Schiller, L., Soffer, E., Spiegel, B., & Quigley, E. American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation. Americal Journal of Gastroenterology. 2014: Volume 109: Supplement 1. S2-S26. Retrieved from http://gi.org/wp-content/uploads/2014/08/IBS_CIC_Monograph_AJG_Aug_2014.pdf Retrieved on: 24-03-24

16. Robillard N. Resistant Starch – Friend or Foe?. Digestive Health Institute. 2013-05-10. Retrieved from:http://digestivehealthinstitute.org/2013/05/10/resistant-starch-friend-or-foe/. Retrieved on: 2015-06-07. (Archived by WebCite® at http://www.webcitation.org/6Z7bARSAi)

17. Yadav BS, Sharma A, & Yadav RB. Studies on effect of multiple heating/cooling cycles on the resistant starch formation in cereals, legumes and tubers. International Journal Food Science & Nutrition. 2009: Volume 60: Issue 4. 258–72. doi:10.1080/09637480902970975.

18. Esmaillzadeh A., Keshteli A., Hajishafiee M., Feizi A., Feinle-Bisset C., Adibi P. Consumption of spicy foods and the prevalence of irritable bowel syndrome. World Journal of Gastroenterology. 2013: Volume 19: Issue 38. 6465-6471. Retrieved from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801318/pdf/WJG-19-6465.pdf. Retrieved on: 2015-06-07.

19. Monash University. The Monash University Low FODMAP Diet. Monash University. 2015c : Edition 5. Ordered from  https://www.monashfodmap.com/i-am-a-health-professional/fodmap-resources/

20. Swain, A, Soutter, V. & Loblay R. RPAH Elimination Diet Handbook: with food & shopping guide. Allergy Unit, Royal Prince Alfred Hospital. 2011.

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Happy Sunday everyone. Who needs a weekend pick-me-up? I know I do. I promise you this recipe won’t disappoint.

Say hello to my low FODMAP cheesecake.

It has a golden crunchy biscuit base layered with a smooth and tangy vanilla cream cheese filling and topped with pops of passionfruit. If you are not a passionfruit fan, then that’s okay just sub in your favourite fruit.

This recipe is low FODMAP (yes there is lactose free cream cheese) and gluten free. You can find the recipe on alittlebityummy.com or follow my profile link.

PS I’d also love to know your favourite cheesecake flavour so leave me a comment below👇

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It’s meatless Monday! What’s on your dinner menu today? Leave me a comment below 👇

On our menu is a low FODMAP vegan chili.

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End of summer veggies are the best and these roasted eggplants are call my name right now.

These are super simple too - roast the eggplant in oil, salt and pepper until golden and tender. Smother in golden sunshine tahini sauce and sprinkle with toasted seeds.

If you are low FODMAP the 1 small-medium eggplant = 4 servings.

Sunshine tahini dressing:
1 tsp garlic infused oil
1.5 tsp gluten free soy sauce
1 tbsp olive oil
1 tbsp lemon juice
2 tbsp water
3 tbsp tahini
1/2 tbsp pure maple syrup

Place in a jar and shake until well combined.

This recipe is part of our premium FODMAP recipe club (along with 700+ other low FODMAP recipes).

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I'm stuck at the office and I'm staving! Definitely didn't pack enough snacks today... if I could I'd be drinking this right now.

Give me a ❤️ if you want to be drinking this too. Say hello to my low FODMAP strawberry and rhubarb smoothie.

Strawberries and rhubarb make the best smoothie buddies. It might sound like an odd combo but the tanginess of the rhubarb pairs super well with the sweetness from the strawberries to create a refreshing and vibrant drink.

1 serve 👇

🍓140 g (1 cup)fresh or frozen strawberries
🍓60 g (1/4 cup)stewed rhubarb
🍓250 ml (1 cup) low FODMAP milk 
🍓2 tsp pure maple syrup (add to taste) 
🍓1/2 tsp vanilla essence
🍓6 ice cubes (use if you are using fresh strawberries)

METHOD
Slice the strawberries in half, be super careful doing this if they are frozen. Place all the ingredients in the blender. Add the ice cubes if your strawberries aren’t frozen.

Blend until smooth. Taste and add a little bit more sweetener if it’s too tangy. The tanginess will depend on your stewed rhubarb (ours wasn’t sweetened).

Pour into your favourite glass and enjoy! 

FYI this recipe is also in our premium recipe club.

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It’s brunch time! It’s also Valentine’s Day so I thought I’d treat my man to a cooked breakfast. Say hello to my Greek scrambled eggs.
 
Serves 2:

1 medium-sized ripe tomato (diced or grated)
1 tbsp fresh chives (finely chopped)
1 tbsp fresh parsley (finely chopped)
2 tsp garlic infused oil
2 tsp olive oil 
3 eggs (beaten)
Salt and pepper

Fry the diced tomato in the garlic infused oil for 2 to 3 minutes until the liquid reduces. Then add the olive oil, chives and parsley to the pan along with the beaten eggs. Season with salt and pepper. Move the egg mixture gently around the pan for 1 to 2 minutes until the eggs are cooked to your liking.

Serve on toast of your choice (we used gluten free bread). Enjoy!

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Who loves eating the rainbow for dinner? 🙌 I do! 

It's hot here at the moment which means rice paper rolls make a refreshing low FODMAP dinner option.

I love that you can prep all of the ingredients in advance so you don't have to slave over a hot stove in the evenings.

What's your go-to summer meal?

P.S. You can get the recipe on alittlebityummy.com or follow my profile link.
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