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  • Jefferson Adams
    Jefferson Adams

    Can Low FODMAP Diet App Help Some Celiac and IBS Patients?

      A new app that can help people zero in on FODMAPs in food might be helpful to people with IBS, celiac disease, and gluten sensitivity.

    Caption: Image: CC--Brett Gaylor

    Celiac.com 03/06/2019 - FODMAPs is an acronym, short for “fermentable, oligosaccharides, disaccharides, monosaccharides and polyols.” FODMAPs is a single name for a bunch of different molecules, common in many in foods, that are poorly absorbed by some people. People who can’t tolerate FODMAPs can suffer celiac-like gastrointestinal symptoms. A low FODMAP diet has been shown to help reduce symptoms of IBS, and could be helpful to some people with celiac disease. FODMAPs have also been shown to play a role in non-celiac gluten sensitivity (NCGS). Now, a new app can help people zero in on FODMAPs in food.

    FODMAPS Trigger Celiac-Like Symptoms in Some People

    In case you didn’t know, there’s a group of carbohydrates called FODMAPs that may play trigger celiac-like symptoms in certain sensitive people. New research shows that reducing or avoiding FODMAPs, which are poorly absorbed by the gastrointestinal tract, can help to alleviate symptoms of IBS. A Low FODMAP diet works by restricting foods that are high in FODMAPs. Some people with celiacs who experience GI symptoms on a gluten-free diet, and some people with IBS may benefit from eliminating FODMAPS.

    High FODMAP foods include, but are not limited to: 

    • apricots
    • avocado
    • beans
    • cherries
    • dairy
    • fruits
    • garlic
    • high fructose corn syrup
    • honey
    • legumes (soy)
    • lentils
    • maltitol
    • mannitol
    • nectarines
    • onion
    • peaches
    • plums
    • sorbitol
    • wheat
    • xylitol

    FODMAPs and Gluten-sensitivity in IBS?

    Some research points to a connection or connections between FODMAPs and gluten-sensitivity in IBS. Doctors have been working to figure out the best dietary strategies, including gluten-free, wheat-free and low FODMAP diets, for the management of IBS symptoms.

    A recent study of IBS patients shows that rye bread low in FODMAPs can reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms, compared to regular rye bread.

    APP Helps You Avoid FODMAPs

    Researchers with the Department of Gastroenterology at Monash University in Australia have developed a diet and related smartphone application to help manage gastrointestinal symptoms associated with Irritable bowel syndrome (IBS) The app is available on both iPhone and Android. Users in over 100 countries worldwide have helped the app become the most popular medical app in over 50 countries.

    Traffic Lights for FODMAPS

    The app is based on a comprehensive database of FODMAP content in food, and lists FODMAP foods with a traffic light system and by serving size. Foods coded red are high in FODMAPs and should be avoided, orange coded foods are moderate in FODMAPs and may be tolerated by some people. Foods coded green are low in FODMAPs and are safe to eat. 

    The app features specific food serving size suggestions help users know how much of a given food is safe to eat. The app also contains other information about IBS as well as recipes and meal ideas to help IBS patients interpret and follow the diet. Proceeds from the sale of the application will go towards funding further research.

    More information about the app can be found on the Monash University website.

    Read more at: Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity



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    This is a very good app.  I use it weekly and it was well worth the small amount I paid to have this information on my phone.  I would also recommend working with a gastro dietitian (yes, they are out there) to tweek this app so it works to it's fullest potential in helping with the FODMAP diet.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Celiac.com 02/13/2015 - Food intolerance is non-immunological and is often accompanied by gastrointestinal symptoms. 
    What can a review of scientific literature teach us about the causes, diagnosis, mechanisms and clinical evidence regarding food intolerance and gastrointestinal symptoms? Researcher M. C. E. Lomer recently set out to critically analyze the scientific literature related to etiology, diagnosis, mechanisms and clinical evidence as it relates to food intolerance.
    To do so, Lomer searched Pubmed, Embase and Scopus for the terms and variants of food intolerance, lactose, FODMAP, gluten, food chemicals. He restricted his search to human studies published in English. Lomer also conducted a physical search for references to these terms from relevant papers and appropriate studies.
    By Lomer’s assessment, food intolerance affects 15–20% of the population and may be due to pharmacological effects of food ingredients, non-celiac gluten sensitivity or defects in enzyme and transport.
    One area researchers now have a bit more solid scientific data about is the role of short-chain fermentable carbohydrates (FODMAPs) in causing gastrointestinal food intolerance. Food exclusion followed by gradual food reintroduction is the best way to diagnose such food intolerance, and to relieve symptoms.
    There is increasing evidence to support the use of a low FODMAP diet to manage gastrointestinal symptoms in cases of suspected food intolerance. A low FODMAP diet is effective, but changes gastrointestinal microbiota, so reintroducing FODMAPs to the point of tolerance is part of the overall management strategy.
    Exclusionary diets should be as brief as possible. They should be just long enough to induce symptom improvement. They should then be followed by gradual food reintroduction to establish individual tolerance.
    This will help to increase dietary variety, ensure nutritional adequacy and minimize impact on the gastrointestinal microbiota.
    Source:
    Alimentary Pharmacology & Therapeutics. Volume 41, Issue 3, pages 262–275, February 2015. DOI: 10.1111/apt.13041 More info on the FODMAP diet from Stanford Univerisity.

    Jefferson Adams
    Celiac.com 06/06/2016 - Irritable Bowel Syndrome (IBS) is one of the most common types of functional bowel disorder. As researchers attempt to unravel the mysteries behind IBS, they have payed increasing attention to the possible impact of food and diet.
    For many people with IBS, certain foods seem to trigger or worsen symptoms, such as abdominal pain and bloating. Wheat is suspected as a major IBS trigger, although which exact aspects of wheat might be involved is not yet known. Gluten, and other wheat proteins, such as amylase-trypsin inhibitors, and fructans, which belong to fermentable oligo-di-mono-saccharides and polyols (FODMAPs), have been identified as possible factors for triggering or worsening IBS symptoms.
    A research team recently set out to examine the issue, especially with respect to gluten and FODMAP sensitivity. The research team included Roberto De Giorgio, Umberto Volta, and Peter R Gibson. They are variously affiliated with the Department of Medical and Surgical Sciences, Centro di Ricerca Bio-Medica Applicata (C.R.B.A.) and Digestive System, St. Orsola-Malpighi Hospital at the University of Bologna in Bologna, Italy, and the Department of Gastroenterology Alfred Hospital at Monash University in Melbourne, Australia.
    The researchers suspect that sensitivity occurs through different mechanisms, including immune and mast cell activation, mechanoreceptor stimulation and chemosensory activation. The lack of certainty regarding the actual triggers has opened a scenario of semantic definitions favored by the discordant results of double-blind placebo-controlled trials, which have generated various terms ranging from non-coeliac gluten sensitivity to the broader one of non-coeliac wheat or wheat protein sensitivity or, even, FODMAP sensitivity.
    The role of FODMAPs in eliciting the clinical picture of IBS goes further since these short-chain carbohydrates are found in many other dietary components, including vegetables and fruits.
    In their review, they assessed current literature in order to unravel whether gluten/wheat/FODMAP sensitivity represent 'facts' and not 'fiction' in IBS symptoms.
    This knowledge is expected to promote standardization in dietary strategies, especially gluten/wheat-free and low FODMAP diets, as suitable ways to manage IBS symptoms.
    Read more at: Gut. doi:10.1136/gutjnl-2015-309757



    Jefferson Adams
    Celiac.com 03/14/2017 - Recent studies of adult celiacs have suggested that complete, not just partial, mucosal recovery and healing is possible, but, in many cases, may take longer than is currently understood.
    Recently Dr. Hugh James Freeman of the Department of Medicine, Gastroenterology, University of British Columbia, Vancouver, BC, Canada, conducted a study to assess healing time in celiac patients. In this study, 182 patients (60 males, 122 females) referred for evaluation of symptoms, including diarrhea and weight loss, were selected only if initial biopsies showed characteristic inflammatory changes with severe architectural disturbance.
    All patients were treated with a strict gluten-free diet, and diet compliance was regularly monitored. Up to 90% or more of patients showed a complete mucosal response or healing, many within 6 months. However, most patients required up to 2 years for full healing and recovery to take place in the gut.
    In this evaluation, women in each of 4 different age ranges showed better mucosal response and healing than men, while elderly celiacs had lower rates overall. Such factors should be considered before labeling a patient with "non-responsive" disease.
    However, celiacs who are diagnosed later, start a gluten-free diet later, and who have inflammatory changes with persistent gut damage may be at increased risk for a later small bowel complication, including lymphoma.
    The overall good news here is that full mucosal healing can and does occur in most people with celiac disease. Some people may take longer to heal, but the evidence shows that most do eventually heal.
    Source:
    International Journal of Celiac Disease, 2017, Vol. 5, No. 1, xx. DOI:10.12691/ijcd-5-1-4

    Jefferson Adams
    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.
    FODMAPs are Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPS are molecules found in food, and can be poorly absorbed by some people. Poor FODMAP absorption can cause celiac-like symptoms in some people. FODMAPs have recently emerged as possible culprits in both celiac disease and in irritable bowel syndrome.
    In an effort to determine what, if any, irritable bowel symptoms may triggered by FODMAPs, a team of researchers recently set out to compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill.
    A team of researchers compared low-FODMAP rye bread with regular rye bread in patients irritable bowel syndrome, to see if rye bread low FODMAPs would reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms compared to regular rye bread. The research team included Laura Pirkola, Reijo Laatikainen, Jussi Loponen, Sanna-Maria Hongisto, Markku Hillilä, Anu Nuora, Baoru Yang, Kaisa M Linderborg, and Riitta Freese.
    They are variously affiliated with the Clinic of Gastroenterology; the Division of Nutrition, Department of Food and Environmental Sciences; the Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki in Helsinki, Finland; the University of Helsinki and Helsinki University, Hospital Jorvi in Espoo, Finland; with the Food Chemistry and Food Development, Department of Biochemistry, University of Turku inTurku, Finland; and with the Fazer Group/ Fazer Bakeries Ltd in Vantaa, Finland.
    The team wanted to see if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, improved transit times, and fewer IBS symptoms than regular rye bread. 
    To do so, they conducted a randomized, double-blind, controlled cross-over meal study. For that study, seven female IBS patients ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day.
    The team used SmartPill, an indigestible motility capsule, to measure intraluminal pH, transit time, and pressure. Their data showed that low-FODMAP rye bread reduced colonic fermentation compared with regular rye bread. They found no differences in pH, pressure, or transit times between the breads. They also found no difference between the two in terms of conditions in the gastrointestinal tract.
    They did note that the gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only once in 14 measurements, and therefore did not follow on par with the rye bread bolus.
    There's been a great deal of interest in FODMAPs and their potential connection to celiac disease and gluten-intolerance. Stay tuned for more information on the role of FODMAPs in celiac disease and/or irritable bowel syndrome.
    Source:
    World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi:  10.3748/wjg.v24.i11.1259

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    Doritos does make a few gluten-free versions.     
    Just wanted to chime in. During my 2 plus years of healing I had joint pain and muscle pain with some of the nightshade mainly peppers and tomato. I stopped them. I can now eat them again. My theory is when my gut gets cc my holey gut dumps some of my food in my blood stream and my already ticked off immune system let's me know what is allowed. Apparently for a time nightshades  of potato, tomatos, and peppers were an issue. I was able to gradually introduce potatoes first and then tomatos, then
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