IBS & FODMAPs
I had just returned from holiday and my mother informed that my aunt had been in hospital next to all of that time. It had been 3 weeks. I went to see my aunt in hospital. She looked pale and anxious, and very tired of being in hospital. She told me she had been diagnosed with irritable bowel syndrome (IBS).
Clearly, food played a central part in this whole saga. I could relate to how tiring planning meals would be when one is sick. In that state, no one wants to think of what meals to cook, let alone muster up enough energy to head to a market to buy produce. It was not something she could handle on her own. I told her that if she could get discharged from hospital the next day, that I would take her to my home and look after her meals and see her back to health.
I began my research on what to feed someone with IBS. FODMAPs appeared to be the main culprit. FODMAPS is the acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols and refers to the different types of short-chain carbohydrates. These are different chemical forms of sugars. For people with a weak gut, these short-chain carbohydrates do not get broken down in the small intestines. They travel into the large intestines. There, bad bacteria feed on these sugars and do what any other living creature would do – respire and reproduce. This leads to 2 problems for the host human: bloating of the belly and an unhealthy gut, rife with populating bad bacteria. This breeding environment could lead to abdominal pain and constipation / diarrhoea.
My aunt’s gut needed to rest and get nourished by low FODMAPs foods. I also excluded insoluble fibres from her diet. I downloaded a mobile app that I found which categorised foods into groups depending on whether they were low / medium / high FODMAPs. Guided by this app, I went wholefoods shopping and introduced low FODMAPs into meals.
Mind you, its not completely foolproof and its crucial low FODMAPs ingredients are introduced back to the tender gut in small amounts. For instance, bell peppers are listed as a low FODMAPs food but my aunt got abdominal pain after eating red bell pepper. Dairy milk was also excluded, and replaced with almond milk. Conventional bread was excluded and replaced with simple gluten-free varieties such a GF Pumpkin Bread. As she gained strength, I baked a GF Zucchini bread for her. It was important to avoid gas build-up so she had to have an appropriate snack when her appetite called for it.
By Day 5, my aunt got her regular complexion back and was smiling. She had not experienced pain for a number of days. It was then time to get her back home with confidence. Throughout the time she was with me, I had kept a diary for her, with a general list of low FODMAPs ingredients I used in her meals, and a list of recipes she could cook up quickly for herself after a long day at work.
With the diary she was clear what ingredients she would buy and the plan was to have ingredients washed and cut-up, all ready for cooking a particular meal, kept in the fridge. This way ingredients could be apportioned and when it came time to cooking, everything was ready and next to no thinking was required. She would not be kept hungry for too long and she would bring extra cooked portions to work for lunchtime the next day. She was to avoid buying foods as there was no certainty what goes into cooking those bought meals.
It was also good that it was over the festive period and she could ease herself back to work with mid-week breaks over the Christmas and New Year public holidays. Its been about a month since she was discharged from hospital and I’m happy to report, all seems to be good with my aunt!
P/S It might be noteworthy to mention that while my aunt was in hospital the in-house nutritionist gave her FODMAPs guide. However, the hospital central kitchen was serving her meals which included regular sliced bread, lentil soup and watermelon, all contrary in aiding the recovery of IBS. Hospitals need to synchronise the treatment for patients through all sections of the hospital tasked with care of the patient. Its elementary. Otherwise how does the patient recover?
- GF : Gluten-Free