FODMAPS. Finally Help achieved with diet. PART I

[Jjay]

Dear UC & Crohns' sufferers.


I am writing this as in the last couple of weeks my condition has greatly improved.

How it all started
about 1.5 years ago I attended a Symposium at the Hilton Hotel in Sydney Australia where a very famous dietician presented. See was speaking about FODMAPs (group of short chain carbohydrates that are poorly absorbed.) I immediately identified with this as she listed a group of foods which I knew that I could not tolerate.


Down the track 1.5 years
I had a phone consultation with a dietician involved with this research. I had given her a copy of a food diary I had been keeping for 3 weeks. She said that I should eliminate some more foods and that my condition would probably improve about 75% and that I could most likely reduce the use of some of my medications after some improvement. I was asked to stop eating onions, green beans, zucchinis, honey dew and apples amongst other foods. I was eating all of these foods almost everyday believing that they very safe and not affecting my condition.


Four weeks down the track
My condition has improved greatly. My constipation I had been suffering for the past 13 years has completely disappeared. The bloody mucous I had been passing almost daily has vanished. Almost all of the bleeding has also gone.



Please give this diet a go. I know it has turned my condition around. The hospital doing the research is the Box Hill Hospital, located in Melbourne Australa.  Here is a link to information regarding the diet written by the dietitican involved with the research. 

[Jjay]

Low FODMAP Diet
Fructose, fructans, sorbitol, raffinose
Gastrointestinal disorders can involve symptoms such as abdominal pain, bloating, wind, reflux, diarrhoea and/or constipation. FODMAPs are a group of short chain carbohydrates that are poorly absorbed. They are therefore fermented by intestinal bacteria releasing gas and leading to these symptoms. You have been advised to avoid the following FODMAPs for a period of at least 8 weeks after which time your dietitian will advise you whether to challenge any of the FODMAP groups.

What Foods Need to be Limited?
1. Foods with EXCESS FRUCTOSE

· Honey
· Apples
· Pears
· Mandarin
· Peach
· Mango
· Watermelon
· Honeydew melon
· Lychee
· Carambola, star fruit
· Nashi fruit
· Coconut cream / coconut milk
· Tinned fruit in natural juice (pear juice)
· Fructose or corn syrup
· Fruit juice (even need to limit safe fruits to 1/3 glass of juice)
· Dried fruit (limit safe fruits to 1 tablespoon)

2. Foods with FRUCTANS

· Wheat (in large amounts)
· Rye (in large amounts)
· Onion – brown, white, spring, spanish, shallots
· Leeks
· Artichokes
· Zucchini

· Chicory - Ecco, Caro drinks
· Dandelion Tea
· Inulin (artificial fibre added to products, e.g. dairy foods)
· Fructo-oligo saccharides (FOS) (artificial fibre added to some nutritional supplements)

3. Foods with SORBITOL

· Apricots
· Peaches
· Nectarines
· Cherries
· Plums
· Apples
· Pears
· Artificially sweetened gums, mints, lollies
· Artificial sweeteners: Sorbitol, Mannitol, Xylitol, Isomalt



4. Foods with RAFFINOSE

· Cabbage
· Brussel sprouts
· Green beans
· Asparagus
· Legumes – chickpeas, lentils, red kidney beans, baked beans
More in next post

[Jjay]

What Are The Safe Foods?

SUITABLE alternatives to honey:
· Jam, marmalade
· vegemite, marmite, promite, Aussie Mite, Mighty Mite, Vege Spread
· peanut butter
· maple syrup, treacle, golden syrup, rice syrup

Fruits that are SUITABLE:
· Berries: blackberry, blueberry, boysenberry, cranberry, raspberry, strawberries
· Citrus: cumquat, lemon, grapefruit, lime, orange, tangelo
· Melons: cantaloupe
· Other: banana, jackfruit, kiwifruit, grapes, passionfruit, pineapple, rhubarb, tamarillo, tomato, avocado, guava, pawpaw, lychee, persimmon
· N.B the quantity of these is important. No more than the size of a small orange at a time. Separate each serve by ~2 hours.

Vegetables that are SUITABLE:

· Alfalfa
· Bamboo shoots
· Beanshoot
· Beetroot
· Bok Choy
· Broccoli
· Capsicum
· Carrot
· Cauliflower
· Celery
· Chilli
· Chive
· Corn
· Cucumber
· Eggplant
· Fennel
· Kohlrabi
· Lettuce
· Olive
· Parsnip
· Peas
· Potato
· Pumpkin
· Marrow
· Mushroom
· Silverbeet
· Snow Peas
· Spinach
· Squash
· Swede
· Sweet Potato
· Sweet Corn
· Taro
· Turnip
· Waterchestnut
· Watercress


SUITABLE alternatives to Ecco, Caro and Dandelion Tea:
· Enjoy tea, coffee (regular and decaffeinated), tea infusions, herbal teas, hot water
Note: Caffeine can be a gastric irritant. You may want to minimise your coffee intake to <2 cups per day if you suspect caffeine contributes to your symptoms.

SUITABLE alternatives to Onion:
· Onion is a MAJOR problem, even when eaten in small amounts
· Check commercially prepared products eg. sauces, soups, canned flavoured tuna
· Consider Asafoetida powder (Indian spice markets) for onion flavour
· Use other herbs and spices to flavour food.
· Garlic is usually tolerated in small amounts (minimise if symptoms persist)
· You may be able to cook with (but not eat) onion:
o Cut onion into large strips for easy removal
o Cut onion into large chunks in stir fries, but leave behind on plate
o Use whole onions in gravies of casseroles and remove prior to serving
o In soups, place onions in muslin bag/stocking while cooking, then remove.

Understanding wheat fructan restriction:
· Wheat-based products are only a problem when WHEAT IS THE MAIN INGREDIENT, e.g. bread, pasta, breakfast cereals, etc,
· Where wheat is an ingredient in only small amounts (eg. biscuit crumbs on the chocolate coating of an icecream) it is NOT a problem.
· There are many wheat ingredients that are safe, as they do not contain fructans. These include:
o wheat starch, wheat thickeners
o wheat maltodextrin, wheat dextrin
o wheat dextrose
o wheat glucose, wheat glucose syrup, and
o wheat colour caramel.

Wheat Free / Gluten Free? There is a difference:
w People who are gluten free cannot have any traces of wheat, rye, oats and barley
w The diet for fructose malabsorption is only low wheat so you can eat rye, oats, barley and small amounts of wheat or wheat ingredients.
w Gluten free products are wheat free, so they are suitable for fructose malabsorption, but you still need to be aware of fructose ingredients such as onion, honey and fruit.

More in next post

[rio1_md]

Thanks for the diet Jjay.

I read an article online several months ago about this and emailed Dr. Gearry at Box Hill Hospital for more information.  He wasn't able to give me an exact diet then (as he recommended first consulting with a specific dietician in Australia and then getting fructose and lactose breath testing done - not easy to do as I'm in the USA) but he emailed me a pdf with a summary of the results of the study on IBD and FODMAPs. 

I don't know whether/how we are able to post pdf's on the forum otherwise I'd post it for others to read (if anyone knows how to do this then please get back to me).

---

Rio, 31 yr old male - diagnosed with UC in 07/2006.

[deacons1]

Do you have links you can use instead of cutting and pasting the entire text? This is getting a little lenghty. Thanks!

---

Tabitha (Tab)

100mg Azathioprine, 2 Fibercon, Colazal-9 a day, Acidopholis Pearls, Nexium

http://www.healingwell.com/donate
Co-Moderator UC Forum

[Jjay]

Wheat Alternatives:

Bread
Problem- Wheat based including:- white, wholemeal, multigrain, sourdough, spelt, kumut, dinkle, flat breads, Rye breads.
Suggested Alternative- Gluten free

Pasta- Regular pasta is made from wheat
Suggested Alternative- Gluten free pasta


Breakfast Cereal
Problem- Most are made from wheat, many also contain lage amounts of dried fruit.
Suggested Alternative- Porridge, cornflakes, rice rubbles, Wheat free muesli. Gluten free cereals.

Noodles
Problem- Two Minute, Hokkein, Udon
Suggested alternative-Rice Noodles, buckwheat (soba) noodles

Cakes, baked goods
Problem-Most are made from wheat. Cakes, muffins, scones, crumpets, croissants, puddings. Fruit cakes are a double problem!
Suggested alternative- Gluten free cakes and mixes (eg. Basco, Well and Good), Cornflour sponge, Flourless cakes.

Savoury biscuit
Problem- Usually wheat based eg. Salda, Sao, Jatz, water crackers.
Suggested alternative- Corn thins, Rice cakes, Rice crackers (check onion powder, Eskal crackers and pretzels.

Sweet Biscuit

Problem- Wheat based eg. Tim Tams, Teddy Bear, Country Cream
Suggested alternative- Gluten free (eg. D’Lush, Eskal wafers, Freedom Foods), Almond Macaroons, Arnotts Rice cookies

Pastry
Problem- Wheat based pies, pastries
Suggested alternative- Gluten Free pasty mixes (Orgran), Eat the middle out - leave pastry behind!.

Breadcrumbs

Problem- Wheat based pies, pastries
Suggested Alternative- Gluten free crumbs (Orgran, Freedom Foods), Polenta, Cornflake Crumbs

Other
Problem- Semolina, couscous. bulgar.
Suggested alternative- Polenta, Millet, buckwheat, Sorghum.

[Jjay]

Hi Tabitha,

Sorry, I do not have links. This is an exact copy of an diet that was emailed to my by the dietitian. I have been sitting here all morning trying to copy and paste the diet for everyone. Only want to help others.

Merry Xmas.
Joan

[Jjay]

Hi TAbitha,

I can send a copy of the diet as a word document if you tell me how to do it.

Joan

[rio1_md]

Hi Joan,

Just in case Tabitha isn't able to post the document, would it be possible to kindly email the entire diet to me? (my email ID is listed on my profile).  Also, in the pdf that I have on the study it mentions the success rate of people on the diet who followed cookbooks that were given to them. Do you know anything about these cookbooks? Thanks for your efforts!

---

Rio, 31 yr old male - diagnosed with UC in 07/2006.

[Jjay]

Hi Rio,

Have just emailed you the entire diet. Please keep me posted as to your success.

Joan

[enan]

Hi Joan can you email me diet?

[potty_girl]

Is this the whole diet on here?

---

Rona

synthroid .088 mg, lowpressor 50 mg x 2, cozaar 25mg x2, imdur 30 mg
nitroquick, proventol, plavix 75 mg, protonix 40 mg x 2, asacal 400mg x 9
carafate 1 gm x 4, zyrtec 10 mg, rhinocort aqua nose spray, fish oil,
potassium.

[rio1_md]

Thanks Joan.  I got your email and replied with the pdf.

[kazygirl]

im interested in more of the diet... is that the lot of it or is there more that your not "allowed" to post cuz of length?

thanx

---

^{steph - 31 year old female - diagnosed UC in 2000}

[Jjay]

Hi Rio

Thank you for attaching the pdf file. Yes you are right as you mentioned in the private email. This is the same dietitcan that I had the consultation with via phone as I am in Sydney and she is in Melbourne. She is involved in the research. She is very nice and I had an 1 hour consulatation with her.

Although he may have told you that diet is good for bloating, wind, diarrhoea and abdominal pain, but not inflammatory symptoms like diarrhoea WITH rectal bleeding, I can only tell you my experience with the diet. It has stopped most of my bleeding. I now see very little if any blood. Most of the time no blood.

Everyones disease if difference of course. I was already avoiding many of the foods mentioned in the diet. I had been avoiding the foods after many years of trial an error. So I only had to eliminate the few I mentioned above (onions, green beans, zuchinis, watermelon and honeydew to name a few. I do not agree totally with the diet as I know that I am unable to tolerate the allowed fruits. But maybe in time, after further healing, I might be able to tolerate the food. ie. I am uanble to tolerate oranges, lemons and the berries at the moment.

Anyone wishing to follow this diet will most likely have an idea what they can and can't tolerate. I was already avoiding wheat and rye. I know that my body does not tolerate rye. If I eat rye, I would be bleeding in approximately 30minutes.

I also recommend keeping a food diary. That way symptoms can be noted.

Hope this helps. Feel free to ask me any other questions.

Joan

---

Joan

[Jjay]

Hello Enan

Sorry to hear your young daughter has colitis. I had already been avoiding most of the foods mentioned. Also, She said that rice was OK. But I think I have a problem with rice. So be aware of what is happening to your daughters body. ie. bloating, rumbling, odour or gas and the odour of her stools, bleeding and mucous. Keep a food diary and note the time the symptoms happened. You may very well find a pattern happening. This dietician does phone consultations. If you are interested I can give you her phone number in Australia via email.

Joan

[Jjay]

Hi Steph,

I see your from the gold coast. Sorry to hear you are not well. This is the whole diet. I can give you a more friendly version if you give me a email address to post to. I tried to copy the whole diet but this forum would not allow it. I have given it to others here.

I think its better if you do this diet in conjuction with the dietician.

Joan

[lulu]

Hi I was involved in recent "FODMAPS" study, thru Box Hill Hospital. Jacqi Barrett is the dietition who was doing the research, Dr Geary was her supervisor, as far as I know he is now back in NZ, but Jaci is contactable on the following email. jacqueline.barrett@med.monash.edu.au

Jaci Barrett, Dietitian, Departments of Gastroenterology and Medicine, Box Hill Hospital and Monash University

[Jjay]

Hi Lulu,

I don't think its appropriate to mention a persons name on the forum. But yes this is the person who I had the consult with. Also the dietition no longer works at Box HILL hospital. If anyone would like her details I can provide them in a private email.

Lulu, maybe you can provide us with some information as well. Do you have UC or Crohns disease and did this diet help you.

Joan

Post Edited (Jjay) : 12/21/2007 8:11:04 PM (GMT-7)

[Jjay]

Rona,

This is the whole diet. I can email a friendly version if you like

---

Joan