Case study ( 3262 views as of March 22, 2019 )
Anna is a healthy 32-year-old female, with a predominantly vegetarian diet. She is known at work for being the "healthiest eater" and has little history of digestive upset. Her energy is great, and stress is not a major factor in her life. She is generally happy and well-adjusted to her job as an elementary school teacher.
Lately, Anna has noticed abdominal bloating on a regular basis, and has started to produce offensive flatulence. She hasn't changed her diet since these symptoms started, and tries her best to focus on eating nutrient-dense foods whenever possible.
Anna decides to book an appointment with her naturopathic doctor (ND) to discuss these concerns, and is relieved to hear that she likely suffers from a sensitivity to FODMAP's, or foods high in sugars that are easily fermented by certain gut bacteria. Anna starts a diet low in FODMAP sugars, and notices immediate improvement in her symptoms of gas and bloating.
FODMAP stands for "fermentable oligosaccharides, diassacharides, monosaccharides and polyols". Currently, evidence supports the use of a low FODMAP diet in managing symptoms of IBS. However, many patients with mild to moderate gas and bloating also respond well to this diet, especially if these symptoms are accompanied by a history of constipation, or sluggish bowels.
Considering some of the foods Anna is avoiding are staples in her diet, like apples, avocados and cauliflower, she is concerned about never reincorporating these foods into her regular diet. During her follow-up visit, Anna discusses her progress with her ND, who explains that composition of gut bacteria, bowel transit time, stress and hydration are additional factors that help predict FODMAP sensitivity, and that addressing these issues often results in decreased FODMAP sensitivity over time.
Ruling out life-threatening presentations is important. Had Anna been suffering from systemic nutrient deficiencies, severe constipation, abdominal pain, a fever, or bloody stool, she may have been referred to a gastroenterologist, or the ER for further examination. A low FODMAP diet is an excellent strategy in managing many cases of benign abdominal bloating. Your dietitian, nutritionist or naturopathic doctor can help you follow this diet, and provide additional support, if necessary.Author: Dr. Kaleigh Anstett