Articles
Why the FODMAP diet doesn't work
By Sharon Hespe · 2 May 2023 · 5 min read
FODMAP tries to be a one-size-fits-all fix for IBS, but gut problems are rarely that simple. Here's why the diet often stalls and what to do instead.
FODMAP is an acronym for:
Fermentable
Oligosaccharides — which include fructans, galactans or galacto-oligosaccharides
Disaccharides — lactose
Monosaccharides — fructose
and
Polyols — sorbitol and mannitol
Confused yet?
Well you should be.
I'm confused and my job is to help people sort out their gut problems.
One of the reasons the FODMAP diet doesn't work is because it's far too confusing and complicated. It's a medical version of 'you've got gut problems, just go on this diet'. You'd have thought the medical world would have realised by now that there isn't a one-size-fits-all diet for anyone, and that is what FODMAP tries to do — it tries to be one-size-fits-all. Usually people try a FODMAP diet and see some improvement, but they become disheartened because they are still getting symptoms and their diet is too restricted — and there is no end point.
If you have gut problems, the key is to find out the cause, remove only the foods that are necessary to remove, and at the appropriate time reintroduce them.
If fermentable foods are problematic, it's likely that you have a SIBO problem, and reducing fermentable foods for a short amount of time will make a difference — but it's also necessary to do some work with your gut. Why are the fermentable foods a problem? Is it because your migrating motor complex isn't working well? Is it because the food is sitting in your gut fermenting and creating gases when it should be in your large intestine breaking down?
If oligosaccharides and monosaccharides are a problem, it's likely you have some form of fructose malabsorption, and if this is the case it's important to reduce down the fructan/fructose foods in your diet. Do the work repairing the gut and reducing inflammation, and then slowly reintroduce the fructose/fructan foods into the diet starting with the lower fructan/fructose foods first.
A FODMAP diet also doesn't take into consideration food intolerances or sensitivities, gut dysbiosis, parasites, salicylates or histamine sensitivities, which are all common problems that may also be going on.
So — if you've tried a FODMAP diet and not seen much success, it's likely because you have something else going on in your gut. You don't just have IBS — there is something going on and the cause is yet to be found. That's where I come in — I help to find the cause of your gut problems.
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