10 Things you may NOT know about the low FODMAP diet

Just a little food for thought!

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What you should know about FODMAPs PDF

312 replies on “10 Things you may NOT know about the low FODMAP diet

  • Nan

    Hi Kate,
    I have recently found the low FODMAPS diet and it has changed my life!!!!! Thank-you to Elise’s blog, and then I found you on line. I live in the Boston area and I would like to consult with you – is that possible? Can my physician write a referral? I could use some help navigating this new path….

    Reply
    • katescarlata

      It is a great diet approach that has helped so many people! Yes, you can consult with me. My office in Boston is in West Roxbury and the phone # is 617-469-4000. Hope I get to meet you!

      Reply
    • Sally

      I have been following the fodmap plan for a week and first few days were great but now bloated again and constipated any advice….

      Reply
    • Gail

      Kate, I couldn’t find your email address…so i hope you see this email. I may be in denial, but I still am wondering if light soy milk by SILK or Whole Foods (365 brand) Is acceptable on a Low Foodmap diet–Thanks! Gail

      Reply
      • katescarlata

        Gail, if the silk milk contains whole soybean and I believe that to be the case in the 2 brands you mentioned–then it would likely contain FODMAPs. The only US brand that I know might fit the criteria is 8th Continent.

    • Zoe levitt

      Hi Kate
      My Dr. recently told me about the FOD diet and I just found your site! Thank you very much for taking the time to do this. I will spend the next week or so educating myself about this diet and I have happily subscribed to your blog. Your blog makes me feel supported in my effort to learn about a different way of eating. Anyhow I wanted to ask you if wheat berries are low FOD?
      With thanks, Zoe

      Reply
  • Mary McCormick

    Thank you so much for this site. I am beginning to follow this diet to the letter. Although I probably don’t have IBS I do have dyspepsia (4 months since onset) and after tons of gastro tests to rule out other diseases my doc has suggested I follow this diet. I am so glad you are keeping it updated. I have already found that enzymes do cause pain for me. I will also drop the probiotics and check labels more carefully on other items. Although I have some food science background I will also seek out the assistance of an R.D. if I can find one familiar with FODMAPS in my community. Again thank you. You are doing people a great service. Mary

    Reply
  • Mary

    I am planning to start the FODMAP diet Monday. I live in Alaska and there are no dieticians here familiar with the diet. How critical is it to have a dietician? Do you know any one here who can help?

    Reply
  • kai loon

    Hi kate, heard from some website brown rice flour/brown rice contain fructans which is unsafe.. So for items containing brown rice flour, are they safe for frucmals?

    Reply
  • Stephanie

    Hi Kate,
    Question regarding beets. I noticed having a few slices are okay according to your list. What is your opinion on both juicing a beet and using one when making a vegetable stock?
    Thanks!

    Reply
    • katescarlata

      Beet root has fructans and GOS if used in a stock they would leach into liquid and you would then consume them…if you added just a few slices as allowed that would be fine, same for juicing.

      Reply
  • esther

    I am confused about soy beans. I see it as a Fodmap but notice you use soy sauce in many recipes. What is the difference?

    Reply
  • Lisa Raphel

    Hi,
    In the March 14 post from Mary, she states she is dropping her probiotic. You are generally a proponent of probiotics that don’t contain FODMAPS, correct? Thank you. Lisa

    Reply
    • katescarlata

      I think most of us could benefit from a probiotic–but finding the right probiotic is not a one size fits all approach. Some of my clients seem to be better without one. Probiotic science is still in it’s infancy so we still have a lot to learn. For what’s it worth, I use a probiotic only when my symptoms of IBS get aggravated and very sporadically otherwise.

      Reply
  • esther

    Are goat cheese, fresh mozzarella cheese or feta cheese low in lactose and therefore allowable on Fodmaps? I know that you list mozzarella (and feta) on your low fodmaps shopping list, but I don’t know if the mozzarella is the fresh kind or the hard kind. I would love to treat myself and my husband to some fresh mozzarella, tomato, basil, and olive oil, but I don’t know if I dare.

    Also, I’m a bit confused about feta. It’s on your shopping list, but perhaps the amount should be limited for me. I had an omelet yesterday with 2 eggs, a dash of lactose free milk, 3 kalamata olives, diced, a small tomato, diced, and about a 1/3 cup of crumbled feta cheese, all sauteed in a small amount of butter and olive oil. All were fodmap friendly ingredients, yet I bloated. Not the huge kind of bloat that I can get; more like 4 months pregnant than 9 months pregnant! Any suggestions as to the ingredient that might be the culprit?

    Reply
  • esther

    Kate, in addition to my question above about fresh mozzarella and feta cheese and if they are high in lactose, is miso paste fodmaps friendly? Miso paste is fermented soy and is an ingredient in something kind of yummy that is sold at the local health food store that is OK re fodmaps on all other counts.

    Thanks,
    Esther

    Reply
  • Susan

    So excited to find this website. Can you please let me know if you addressed esthers questions on cheeses posted on 8/14/12? I am very curious what the answers are. Thanks!

    Reply
    • katescarlata

      Hi Susan, I am sorry I tried to find the comment you were referring to and couldn’t find it. I can tell you that most cheeses are allowed on the low FODMAP diet except particularly wet cheeses that still contain a fair amount of the whey (cottage cheese, ricotta) When cheese is made the proteins curdle and rise to the top and the whey –which contains the lactose is drained off. Cheddar, Swiss, Parmesan, even feta and brie are okay. The very soft mozzarella is okay too. Parm, Swiss and Cheddar have virtually no lactose while some of the softer cheeses may have 1-2 grams. Many individuals can tolerate some lactose in their diet–say up to 4 grams per sitting–but that is very individual.

      Reply
      • Susan

        Thanks Kate for the very helpful info!! So, does this mean whey protein (as in the powder) is a no-no? REALLY appreciate your time.

      • katescarlata

        Susan, Whey protein alone should be fine–as FODMAPs are carbohydrates not protein-but sometimes products labeled whey protein concentrate vs. whey protein isolate may have some lactose. I know…it’s a bit confusing.

      • Lorrice Gordon

        Thank you so much for the info on cheese. This diet was recommended to me because of some intestinal surgery. I was already freaked out about going gluten free and lactose free. Knowing I can eat some cheese will make it so much easier! I found this blog so helpful.

  • Diane Walker

    Kate,
    Thank you so much for the great information on your website and book. After 1 year of suffering from complications from food poisoning I am finally getting back on track following the FODMAP guidelines. Could you clarify for me about King Arthur Flour. This is the flour I have always bought (being born in VT!) It is on the shopping list for low FODMAP foods but wheat/flour in on the HIGH Fodmap food list. Any advice would be great.

    Thank You
    Diane

    Reply
  • Jennifer Green

    Hi Kate,

    Thank you for all your helpful information! I just stumbled upon this FODMAP diet while doing research on IBS and it makes sense. I would like to approach a new style of eating with the expertise of a dietitian but I am having a hard time finding someone in the western part of our state (MA). Could you recommend someone out here?
    Thanks.

    Reply
  • lia

    Hi. I am looking for a substitute for tomatoes that is fodmaps friendly. I used to make “no-mato” sauce from beets and carrots but i bloat even after removing the garlic from the recipe (replaced that with garlic infused EVOO). Also, are ground flax seeds safe? I make microwave gluten free muffins with Jorge Cruz’ recipe but am flying blind on flax.

    Reply
    • katescarlata

      Beets are one of those moderate/high FODMAP foods so they could still be causing you some symptoms in a sauce…can you make it with only small amount of beets and heavier on the carrots? The only data I have on flaxseed is in a mixture more commonly used in Austrailia called LSA (Linseed, Sunflower, Almond mix)– Linseeds are Flax. So in that mixture the cut off is 1 Tablespoon. So I think if you keep the serving of flax per serving –1 Tablespoon you should be okay. Hope that helps Lia.

      Reply
      • katescarlata

        Olive that would be correct and thank you for bringing that to my attention. One Australian Tablespoon is more than US–it’s like a Tablespoon + 1 teaspoon.

      • LA Rosen

        This info on flax is very useful. We’re trying to get a bit more fiber back in the diet, but very carefully. Breakfast is usually rolled oats with small amount of safe fruits (bananas, blueberries, pineapple), a bit of nuts (pecans or walnut pieces) or a swirl of peanut butter or pumpkin; and lately we’ve added a tsp or two of freshly ground golden flax. Trying to monitor, but hard to know if whatever transpires through the day is from breakfast, or the lunch 2 hours later, or the mid-afternoon snack…. Trying to keep to just one new thing, or increased portion a day. We’ve also started trying very well rinsed quinoa (cooked in homemade broth) at dinner for added protein. Your site gives so much added useful info. Thank you for creating and monitoring this valuable resource.

  • Lindsay Willard

    Hi! Can u recommend a dietician in So cal that is familiar with fodmap? My 7 year old has FM and ongoing SIBO. The dietitians at pedi hospital regurgitate info off the Internet and try and help but I need someone who can help us as my child refuses to eat and feels miserable- thank you so much! Maybe we could come to you? If you could help us I would seriously do it. Thanks, Lindsay Willard

    Reply
    • katescarlata

      Lindsay, Have they treated your daughter for the SIBO?
      It’s hard to eat when you have SIBO–food often = pain.
      I reached out to a colleague at UCLA med center–would that work for you?
      Let me see what I can find out.
      I occasionally do Skype or phone consults so if you can’t find someone close to your home–which is always best-then perhaps we could consider that route.
      Best to you!

      Reply
  • Ashlee

    I was just diagnosed with IBS on Friday and told to follow a low FODMAP diet, can you send some recommendations as I do not eat beef or pork only chicken fish and shrimp, please help

    Reply
    • katescarlata

      Nicole, It can be helpful for those with Crohn’s disease. Particularly because individuals with Crohn’s are at higher risk for malabsorbing fructose. But, I would encourage you to seek assistance with the diet from a knowledgable dietitian.

      Reply
  • Isabel

    Hi Kate,
    I’ve been experiencing IBS-like symptoms for the past 6-8 months (although not diagnosis has been made, many other things have been ruled out by lab tests).
    Have decided to try this diet plan to see if I see any alleviation of symptoms (mostly a lot of bloating).
    I’ve heard mixed things about sweet potatoes (concerns with mannitol). I’m disinclined to give them up because they’re a pretty big part of my diet. Any insight? I stick mostly to Japanese sweet potatoes.

    Reply
    • katescarlata

      Hi Isabel. Sweet potatoes are a source of mannitol and this is a sugar alcohol (Polyol source.) Mannitol malabsorption is less common than sorbitol so perhaps you will tolerate them just fine. Many of my clients have been able to tolerate other mannitol sources such as cauliflower and mushrooms.
      If you could try to limit to 1/2 cup serving at a sitting–you will be under the mannitol limit–perhaps try that for the first 2 weeks of the elimination phase and then try to re-challenge your diet with the sweet potatoes at that time.
      You could have 1/2 cup sweet potatoes 3 times per day –as long as you spread them out over the course of the day.

      Reply
  • Linda Lee

    Many yrs ago when all the autoimmune problems started for me, a GP told me most likely the bowel problems I was having were IBS. Not till recently when BLOATING AND PAIN became so prominent have I decided I NEED to really check this out…and my Living Without Magazine had that article about you and wala, FOUND your blog and such..ordered both your book and Patsy Catsos..am looking forward to learning a new way of eating to be painfree. THANKS for all you are doing!!

    Reply
    • katescarlata

      So glad you came by my blog Linda!! And I am so glad Living Without did a feature on FODMAPs–just wish more media outlets would talk FODMAPs! And glad you think Lucy is a adorable….she is cute and a HANDFUL!!

      Reply
  • Cindy

    Hi Kate,
    I have been battling IBS for the past 8 years. I eliminated all dairy from my diet for five years, but continue to have symptoms. Just learned of the FodMap diet from a friend of a friend. As with most people, this is seriously effecting my life. Can you recommend a dietician who is in the Portland, Oregon area? Thank you!

    Reply
    • katescarlata

      Hi Cindy, my colleague Patsy Catsos has a dietitian registry on her site and I have attached the link here–>http://www.ibsfree.net/FODMAP-Friendly%20Dietitian%20Directory1.pdf
      There is one RD I believe on the above link from Portland.
      Discuss the possibility of small intestinal bacterial overgrowth with your physician too as I find many of my IBS patients suffer from this condition as well.

      Reply
  • talli

    I have a question about sugar made from beets. Is that okay or not okay on low FODMAPs? (I seem to have special intolerance, within FODMAP diet, for beets).

    Also, what about beetroot fiber, which is in some gluten-free flours? I seemed to have a bad reaction after making a cake with that kind of flour. Could that be the culprit? (It also has tapioca, sarrasin (buckwheat), and carob). Thanks!

    Reply
    • katescarlata

      I believe beet fiber would be a FODMAP source. What I have seen about beet sugar–it appears that it would be okay and allowed BUT I have not seen actual Monash data on this –so use with caution.

      Reply
      • Pete

        I’ve just startet on a FODMAP diet and bought four different kinds (and brands) of gluten free breads for the occasion. They do however all contain sugar beet fiber. Your blog has the only mention I can find of beet fiber and FODMAPs. Do you (or anybody) know anything more about it?

        Thank you!

      • katescarlata

        Pete–not sure we know much about sugar beet fiber & FODMAPs. Would suggest you try Udi’s white sandwich bread –which at most recent check seems to be suitable….and has been well tolerated by my clients. The whole grain Udi’s seems like it might be okay–small amount of molasses but should might be okay. I have noticed that food manufacturers are adding sugar fibers and corn fibers–and I can’t say for sure that these would be suitable on the low FODMAP diet.

  • Claire

    Thanks for the helpful blog, Kate. I’ve been on the low fodmap diet for a few years (through ShepherdWorks in Melbourne), and am thankful for the dramatic reduction in IBS pain. We’ve moved to Switzerland, and now have the challenge of reading ingredients in other languages! There are a number of products I find it difficult to buy here, e.g. debittered soy flour. Can you suggest a substitute?

    Reply
      • Elizabet

        Hi Kate. I was just doing some Googling for “buckwheat fodmap” and found this post. I love buckwheat flour for baking and I’ve read it has tremendous anti-cancer attributes. However, the Monash app lists only buckwheat kernels (which would then just be ground into flour), and it lists them as high FODMAP. Has there been an update to the status?

      • katescarlata

        Elizabeth–I have not seen data on buckwheat flour—but may be different depending on the processing and the fiber content left in the flour product. Buckwheat kernels are limited to 1/4 cup–this would be the whole grain.

      • Heidi Peyser

        I posted this just now but didn’t have the notify by email part checked. please respond to/approve this and not the other.

        I’m on week one of the elimination phase and I keep having this odd experience where gluten free products that looks safe on the ingredients front immediately tingle going down. The only thing I can come up with so far is that they both were made with flours which are resistant starches.

        I have found a lot of material suggesting that resistant starches act like the F in FODMAP.

        Can you please comment on this?

      • katescarlata

        Resistant starches are fermentable in the colon–so they can cause gas. They are made of longer chains of carbohydrates compared to FODMAP–so are not as likely to pull water into the intestine as FODMAPs do.

  • simon petkovic

    hi kate,
    a lot of useful info on this blog.had an illeosecal resectioning in 1998.doctors never established what exactly is causing my continued symptoms-diarrhea,bleeding,sore rectal area (proctitis?).have done a number of tests,colonoscopies etc etc bla bla.i seem to be sensitive to most foods prohibited on the fodmaps diet.also to fried foods,all cereals,all soy products-the list of foods are far greater than the list of foods i can tolerate.any suggestions on what to eat in order to cure/improve a sore rectum and fluctuating blood sugar levels (my villi seem to be not functioning properly after years of being aggravated by foods i shouldn’t have been eating)?also-how to get rid of ongoing diarhea and improve my bowel motions?and finally-a good r.d. to contact here in melbourne.thanx so much!

    Reply
  • Kristin

    Hi Kate,

    I just found your site today while researching FODMAPS info. After years of gastro visits, testing and failures, I have figured out that I have a gluten intolerance, so have been avoiding that for 3 years already. I normally eat a very vegetable/fruit/protein/dairy diet, but have recently started a Whole30 (sort of Paleo) that also restricts sugar and dairy. Since starting it, and obviously eating more protein and vegetables than normal, my stomach is very distended and feels full all the time, exactly like when I eat gluten. I have always wondered about onions (they give me a headache when cooking them, so I’m thinking my body is telling me they’re not what it wants) and sometimes garlic is offending as well. I live in Hopkinton, Ma and would love to get involved with someone that is familiar with these kinds of issues. Are you local (I saw Boston) or can you recommend someone else that might be? Thanks, Kristin

    Reply
  • katescarlata

    Oh yes, Michelle, the Monash University low FODMAP diet app is very user friendly and such a great tool for patients and health care professionals alike. I am so grateful that the Melbourne, Australian researchers put it together.

    Reply
  • Kristen

    Hi Kate,
    My 6 year old has had an ongoing issue with constipation and GERD. He has been treated for both but without a lot of success. Recently he was tested and found to have Bacterial Overgrowth Syndrome. He is now on his second round of flagyl but experiencing a lot of nausea and gas. His GI suggested the Fodmap diet. I noticed he eats some of these foods in large amounts (Watermelon, milk, pasta, apples, cheese). Do you think just elimating the foods he eats a lot of would give him some releif or do you think all food listed should be avoided? Thanks for all the wonderful information.

    Kristen

    Reply
    • katescarlata

      Kristen, I would encourage you to work with a dietitian. It wouldn’t be prudent to advise you via the blog on what’s best for you son without understanding his normal intake, nutritional needs, past medical history etc…and this is done thoroughly with a dietitian. That being said…I find it’s best in most circumstances to do a complete elimination diet for 2 weeks to get a better understanding of what foods are problematic. Certainly in the elderly,malnourished and pediatric population, for example, the full elimination diet may be too restrictive and I would opt for a more liberal approach and simply limit the foods most often consumed with the highest amount of FODMAPs. Hope that helps. Of note, ensuring adequate fiber in those with IBS-C (constipation) is key from my experience. Here is a little info on low FODMAP choices and fiber content: http://blog.katescarlata.com/fodmaps-basics/fiber-without-fodmaps/ Also, chia seeds are a great source. 1 TB has 5 grams of fiber!

      Reply
  • Missy

    I have been an IBS sufferer for along time now, and find its very debilitating. I am also Lactose Intolerant. I have just found out about FODMAP. Which meats should I avoid? Are there any types of FODMAP friendly, lactose free milk brands available that I can use in recipes. I am finding this transition very difficult and know that I must stick to it in order to get my life back. Can you recommend any books/recipe books?
    Thank you.

    Reply
    • katescarlata

      Hi Missy, FODMAPs are carbohydrates and meats are carb free so all meats are allowed…unless of course, prepared with FODMAP containing ingredients such as honey ham for instance–honey is a FODMAP. Lactose free yogurt such as Green valley is well tolerated. Lactaid milk and lactaid cottage cheese should be okay too. For review of the elimination phase of the diet, IBS Free by Patsy Catsos is a great book and for recipes I have plenty on this blog but also in my low FODMAP downloadable cookbook link here: http://www.katescarlata.com/fodmap.htm

      Reply
  • Louise

    Still in diagnosis stage but GI reccommended FODMAP diet. Can you tell me if Mirin would be tolerated on diet? Also Splenda? What about roasted garlic? My tests came back negative for Seliacs and lactose intolerance. Have yet to take fructose test, CT entrorography and endoscopy but main symptoms are diarrhea. Some bloating. It sounds like the people with IBS have more problems with bloating. Also colonoscopy did not show any abnormalities.

    Reply
    • katescarlata

      Louise,
      My guess is that Mirin as a sweet wine would not be low FODMAP. I am not a fan of splenda but it should not be a FODMAP. There was one study that suggested it reduced beneficial gut bacteria. Fake foods for all of us, should be kept at a minimum, right? The low FODMAP diet is very helpful in the management of diarrhea so hopefully it will help you out.

      Reply
  • Louise

    Thank you for the information. I am trying to navigate a lot of information. I just finished a six week low residue fiber diet and so many foods I could not eat on that diet are allowed on FODMAP and vise versa and it is all so confusing. BTW- the low fiber diet did not help at all. So the allowable sweeteners on this diet are maple syrup and sugar. Is that right?

    Reply
  • John

    I am just about to begin this diet I was diagoised with IBS and have massive bloating when I eat so I am hoping this will help relieve some of my symoptoms. I live near the Washington DC area and was hoping you could refer a great dietician I could speak with.

    Thanks.

    Reply
  • talli

    Hi,
    For some reason my Q from Feb 15 was not answered. And I’d love to know if you have any wisdom.

    It’s a Q about substances often used in desserts or as thickeners. Is agar agar (derived from seaweed), or also grass jelly (cincau – a plant) powder allowable? I saw this (unanswered post) about the subject here:
    http://fodmapsdiet.com/2013/01/11/pancake-for-one/#comment-1651

    Do you know if either of these foods are okay for low FODMAPS? Thanks!

    Reply
  • Carol Anheier

    Several years ago my Gastroenterologist diagnosed me with Chrons and six months ago said he made a mistake and that I had IBS. Well, I have had IBS for many years and a year ago was tested for food intolerance. Results showed that I am Gluten intolerant, casein, lactose, egg yolks coffee and many other foods. Fatty greasy foods also make me sick. Walking outside for exercise is impossible and I dislike mall walking. I love to travel and that has also become very difficult. I first saw FodMap mentioned in Living Without Magazine and am very excited about finally having something to help me. I live in Wisconsin and need to find a diatician who can help me. The Gastroenterologist has been no help. Do you know of anyone in the Appleton, Green Bay, Madison area? In September we have a Pilgrimage scheduled to France and I would like to have this under control before then.

    Reply
  • Louise

    Hi Kate,
    I just ordered your book and one other on IBS. my doctor has not given me a diagnosis yet, but I took the fructose test this week and my hydrogen level was four times higher than normal range. I am now looking at information on fructose malabsorption information. I did not test high for lactose intolerance. Would you still recommend the strict FODMAT diet? I checked for a dietician in NM on the web site and there are none listed. Louise

    Reply
    • katescarlata

      Louise, be sure to be tested for small intestinal bacterial overgrowth which often goes hand and hand with fructose malabsorption(FM). Typically, yes, the diet for FM would be a low FODMAP diet for 2-6 weeks followed by the re-challenge phase to evaluate which FODMAPs trigger symptoms.

      Reply
  • Louise Broadbent

    Kate, Thank you so much for your help. When I return from my trip I will ask my GI about the test for small intestine bacterial overgrowth. I had been scheduled for a CT entorography (sp?) and cancelled. I hope that was not the test for bacterial growth. I just wanted to make sure I was not doing a lot of unnecessary tests. The nurse from my GI said they were requesting a referral for a dietician. I feel I am on the way to better days. Thanks again. Louise

    Reply
    • katescarlata

      Hi Louise, the small intestinal bacterial overgrowth test is typically a breath test. So happy to hear you will be working with a dietitian. Good luck and YES…on your way to better days!

      Reply
  • Signe

    Hi Kate

    can you tell me if I can eat Misosoup as part of a low fodmap diet? The ingredient I am most uncertain about is soybeans.

    Thanks so much in advance

    Reply
  • sandra tassel

    Hello Kate,
    Your blog, cookbook and shopping list are true Godsends for me and my husband, who is suffering from something ever since he took a round of Cipro in December after contracting an intestinal bacteria when we were in Panama. The Gastroenterologist ordered all the tests she could think of but really wanted to go for the colonoscopy. When he resisted she mentioned trying a low FODMAP diet. It helped almost from day one. We are adjusting reasonably well because there are so many decent foods in our local co-op and I like to cook. Turns out giving up soft cheese has been difficult though. What is the rule on goat and sheep products? I know they have different proteins…
    Thank you!
    Sandy

    Reply
    • katescarlata

      Hi Sandy, It’s true, the casein in goat milk products is easier to digest for some…but this is not a FODMAP relationship–as FODMAPs are carbohydrates. Goat and sheep milk would not be allowed due to the lactose content BUT cheeses made with goat or sheep milk should be okay as long as they are not too ‘wet’ meaning that some of the lactose was retained in the cheese. It the cheese is creamy–small amounts such as a couple tablespoon crumbled on a salad should be low enough in lactose.

      Reply
  • Mari

    Hello Kate… my husband returned from the doctor today and she suggested he start following the low Fodmap diet. He suffers a lot from the issues that you discuss: IBS. As a newbie [as of today], what do you suggest I do first? I plan on contacting a dietician in my area [SF bay area CA] but what else should I do while we wait? Any advice would be greatly appreciated! I’m off to read more from your website! Thank you… Mari

    Reply
    • katescarlata

      Mari First be sure you husband has been screened for celiac disease. It’s always important before you take wheat out of the diet -even for the short term-that he be tested for celiac which can have some overlapping symptoms with IBS. Celiac testing is inaccurate without wheat in the diet. Patsy Catsos’ book, IBS free at last is a great reference when starting the diet. And of course, work with a (FOdMAP knowledgeable) dietitian to ensure your husband is doing the diet correctly and with healthily.

      Reply
  • Susanne W.

    AFter trying 4 rounds of different antibiotics, the FODMAPS immediately took care of my IBS. Now I need to figure out how to put foods back in. Any dieticians recommended in the Philadelphia and surrounding suburban areas?

    Reply
  • Laurie R.

    My doctor recommended the low FODMAP diet plan today to me. Can you recommend a dietician in the Fort Myers, FL area? Thank you!

    Reply
  • Sabrina

    This website is AWESOME! I am day 20 on my Whole30 challenge and recently discovered the low FODMAP diet. I initially started Whole30 to ease my IBS troubles, and so far my stomach actually feels worse =(. I did some research and found out about FODMAP and the whole shebang behind it. I have the bloaty, gassy, gurgly, dread eating kind of IBS and I am sick sick sick of it. Whole30 has it’s benefits ( I do sleep a whole lot better) but I am still having issues with my stomach. As soon as I am done with Whole30 I plan on committing to the FODMAP elimination diet to see if it helps. Unfortunately I can’t find any local Houston, TX dietitians who specialize in FODMAP so I figured maybe someone on here can help me out. Any pointers, advice, resources, support would be GREATLY appreciated! I also have a food journal/blog and document everything I eat on: whole30fortheworkingirl@blogspot.com, if you check it out maybe you can give me some pointers as to what I’m doing wrong?

    Reply
  • Sarah

    I am very new to the low FODMAP diet and am trying to figure it out. I have Celiac Disease that is well controlled and already know that I do not tolerate hardly any grains at all. I am wondering if dried (unsweetened) coconut is allowed. What about unsweetened coconut milk? Thanks.

    Reply
  • STEVE

    I’ve just been told about the Lowfodmap diet and am trying to work out what foods I can eat.This site is very enlightening because the questions are often those I had not thought to ask.
    Great site,thanks

    Reply
  • Pat Skinner

    Hi Kate, My husband has cholangiocarcinoma and watery diarrhea usually after eating. The doctors say the secretory diarrhea is caused by the chemo and he has lots of meds for it, but it is an ongoing problem. I am trying the fodmap plan because he eats lots of carbs due to taste changes. Do you have any suggestions that might be helpful?

    Reply
    • katescarlata

      Hi Pat, I wonder if it might be possible to meet with a dietitian in your area that specializes in digestive health. It seems to me that your husband would benefit from a nutrition evaluation and take into account his medical history to find a nourishing, tasty and easy to digest diet for his health condition.

      Reply
  • lynn cardy

    I have just discovered your website and think it’s truly enlightening. I live in London UK and am looking for a nutritionist/dietician who is really conversant with the FODMAP diet. Finding that a bit tricky so wondered if you had met with any while doing your own research?

    Thanks so much

    Reply
    • katescarlata

      Lynn- Kings College London runs a FODMAP course for dietitians. I have reached out to Emma Carder who practices in the UK and is very knowledgable in FODMAPs to see if there is a list of dietitians that have taken this course. Stay tuned.

      Reply
  • amy

    Hi, after 2 years of stomach pain for my 6 year old, I just discovered this list and have already found that the things with high FODMAPs are exactly what make him sick and in pain on the couch for hours. The only time he felt ok in the past 2 years was when I gave him a broad spectrum digestive enzyme before each meal. ( I did this for 3 weeks). So, I know he needs to follow this diet. My question is- why can he not eat things on this list? I know IBS is one reason…what are some other reasons. I want to get to the bottom of WHY he cannot eat these foods with out the help of a digestive enzyme. He saw a GI dr for the first time yesterday…she thinks he is constipated..sigh..( even though he pooped 19 times last week) she obviously has no clue.

    Reply
    • katescarlata

      Hi Amy, first be sure your son is tested for celiac disease. This can be done with a blood test for an initial screening. It’s important before you remove wheat from the diet to test for celiac because the testing is not accurate once wheat, barley and rye (the gluten containing sources in the diet) are removed on the low FODMAP diet. People are sensitive to FODMAPs if they don’t absorb them well. This could be due to small intestinal bacterial overgrowth–the bacteria creep into the small intestine and break down the FODMAPs before they have the opportunity to be digested. Some FODMAPs are not digested by the human body: Fructans and GOS so are often culprit for GI symptoms. Lack of digestive enzymes such as lactase can make lactose, the sugar in milk products non absorbable and thus become food for bacteria. When intestinal bacteria consume FODMAPs they produce gas. In individuals with IBS –a motility disorder—the gas can become trapped causing pain or the gas can be created in the small intestine which has a narrow diameter and so the stretching of the intestine might contribute to pain as well. The doctor may feel stool in his intestine which she is relating to constipation. Many IBSers don’t empty the intestines completely which also plays a role in their symptoms. The gases produced by consumption of FODMAPs by bacteria can play a role in slowing down the intestine (methane producing microbes are linked with this) or sped up by hydrogen gas producing microbes (gut bacteria). It’s complicated biology in the gut!!

      Reply
  • Jade

    Hi Kate,

    I have started to reintroduce FODMAP’s.

    I want to sample onion next but wondered if you had any ideas as to what Type of onion would be best to try and maybe what Amount, if that’s important too….ohhh and Cooked or Raw!?

    I am pretty excited about this test as along with garlic, something I used to eat a lot off.

    Any help very appreciated!!

    Jade….’almost out of the woods!’

    Reply
    • katescarlata

      Hey Jade…Onion seems to be a very hard challenge to pass for many of my clients. I have not seen data on different types of onion so I would try the onion you most enjoy. Stick with small amount cooked or raw, though some find cooked better tolerated–the test amount is 1 Tablespoon. I can enjoy traces of onion in foods such as salad dressing but not big chunks in foods–but everyone is a bit different. Best of luck to you!

      Reply
  • Jade

    Oh blimey, this could be the most challenging challenge yet….

    Thanku very much…. I’m going to go for 1 tablespoon cooked! :-/

    Reply
  • amy

    Hi, my 6 year old has been gluten and dairy free for 7 months. He was doing so much better, but now he is sick all the time again. I have found that he NEEDS to be eating low FODMAP foods in order to feel well. I am so glad I found this site! But, I have a question, he is going to be tested for celiac. Do you know of a low FODMAP food I could give him that does contain gluten? I know Cheerios are FODMAP friendly, but are not gluten free.Any other suggestions for what I can give him? He has to be eating gluten daily for 12 weeks in order to do the biopsy to check for Celiac disease. I want to keep him as low FODMAP as possible to reduce his pain, but he needs to be eating gluten! thanks so much.

    Reply
    • katescarlata

      Amy, I would encourage you to ask his doctor but a few low FODMAP foods with gluten would be 100% spelt bread (whole foods has a brand, French meadows), soy sauce, seitan (gluten rich vegan protein source), small amounts of wheat pretzels might be okay too–try 1/4 cup regular pretzels as a snack (Monash allows these on their app), you might also try sourdough white bread (many of my clients can tolerate it when we do a wheat challenge) or Bay’s English muffins which are a white wheat based English muffins, in the refrigerator section of the grocery store that many of my clients can tolerate too when we do the wheat challenge.

      Reply
  • Louis

    Hi Kate, many thanks for creating such a great online resource. I’ve just started the FODMAP diet this week, I’m a vegetarian, and it is tough. But the improvements I’m feeling already more than make up for it, or though I was heart broken when I discovered I couldn’t drink camomile tea :) One thing I found on another site detailed do’s and don’ts for vegetarians and one of them is –

    ‘Don’t: Stay on the elimination phase for more than two weeks. You need to liberalize your diet sooner than meat-eaters in order to get adequate nutrients.’

    http://www.ibsfree.net/ibsfree_at_last/extras/

    Would you agree with this? Or is it safe for a vegetarian to continue the elimination phase for 6-8 weeks? Any advice would be most appreciated.

    Reply
    • katescarlata

      If you follow the diet and include tofu, tempeh, and small amounts of allowed legumes: 1/4 cup canned chick peas and 1/2 cup canned lentils I think you might be okay to stay on it a bit longer BUT…once your symptoms are managed–and that may only take 2 weeks–you should start the re-introduction/challenge phase. It also depends on if you include eggs, cheese and lactose free milk which would allow for greater variety and nutrients.

      Reply
      • Louis

        That’s good to hear, many thanks. I didn’t realize I could eat some chickpeas, that’s made my day! When you say ‘once your symptoms are managed’ do you mean completely IBS free? My first few days with the diet saw a huge improvement but now in the second week the IBS has come creeping back. The only foods that don’t cause any symptoms are rice, eggs and potatoes, which is obviously a very limited diet :)

  • Jade

    Hi Kate,

    Well it’s been a time since I started my FODMAP experience but with the help of your recipe booklet, within days, I was happy to discover that I was on the right track! Finding FODMAP saved me where nothing else would.

    I have come to share my re challenge! results…..

    Honey – symptoms returned 2 days with nausea.
    Wheat – symptoms returned with nausea and stayed for 5 days.
    Garlic – 1 whole clove fine (haven’t tried more yet).
    Onions – symptoms back for 2 days – no nausea but bloated.
    Lactose – (I was already lacto intolerant)

    And a question regarding…..

    You made an interesting point before that the difference between SIBO being present and Fructose malabsorption is sometimes clear when the FODMAP foods are brought back.

    I have since been interested as to what this meant and how SIBO would show itself.

    I was really interested in what you thought of my results. My thinking is that my ‘suffering’ would have been a lot worse if it was SIBO.

    (I did have a breathe test for SIBO and it was negative, showing both low levels of Methane and Hydrogen.)

    However just in case the results where inaccurate….I am all ears as to what you think….Are my results typical of a food problem rather than SIBO?

    BTW – I should say to anyone reading FODMAP has helped me 10 fold.

    I haven’t had a chance to scoot around the whole website in a while because I have had my head in the fridge most days :D…..but looking forward to trying the banana, cinnamon, coconut recipe!

    I hope the world of food is treating you kindly…..

    Jade x

    Reply
    • katescarlata

      Hey Jade! So happy that you found the recipe booklet helpful! Yay! Not sure about sibo –but seems like you had symptoms but not terrible symptoms–is that correct? You might try a sourdough white bread–many of my clients have found that works for them. I personally wouldn’t push the garlic—I mean who needs more than a clove anyway? Sounds like you passed that one! Onions are tough for most people so no surprise there.

      Reply
  • Jade

    Hi Kate,

    Yes the booklet really helped, gave me a structure!…

    I will give sourdough a try, thank you… I forgot about this one.

    Talk about having to learn about an area with no choice in the matter but worth it.

    Jade – Happy tums to everyone :)

    Reply
  • Ronney O'Donnell

    Thank you so much for your informative and very helpful website. Is there a problem with the alcohol content of pure vanilla extract and a low fodmap diet?

    Reply
    • katescarlata

      The Monash researchers have allowed vanilla in their recipes so I allow it as well. I am not sure they have analyzed vanilla extract. I think the small amount of alcohol should be okay for most people.

      Reply
  • Jade

    Hi Kate and fellow FM peeps,

    How is this possible…I ate 170g of kidney beans lastnight (in a chilli con carne) and had no symptoms?

    Yet I failed the onion and wheat test?

    :)

    Reply
      • Jade

        I just realized that they aren’t the same as fructans, really deceiving on the Monash app for your phone they class them all in the same category…think they should have a separate ‘class’ for the galactoligos.

        Thanks

  • Gail Tauber

    I need a NYC dietician–any to recommend?

    Also anything you recommend for nausea associated with iBS/Dyspepsia?

    Thank you thank you thank you.

    Reply
    • katescarlata

      Gail, Sometimes seeping a small piece of ginger root in hot water and making a tea to sip can easy nausea. Have you had a gastric motility test to rule out delayed stomach emptying?
      NYC based RD I recommend is Tamara–http://www.tamaraduker.com

      Reply
  • Gail Tauber

    Thank you. I had so much ginger and ginger teas that I got sick of it. But I will get back to it.

    I’m supposed to have a gastric motility test soon.

    And thank you for the recommendation. I will contact Tamara.
    Best,Gail

    Reply
  • Jade

    Hi there Kate,

    I’ve noticed a link on google to your website mentioning apple cider vinegar but cannot find the page. So you may have already written about this somewhere…anyway.

    Is Apple cider vinegar a fodmap? or ok to have?

    Many cheers

    Reply
  • Jade

    Hi Kate,

    I’m so sorry …another question ahh.

    I’m looking at a ton of probiotics at the moment. (I had constipation type ibs before I went low fodmap.)

    Could you please suggest a good probiotic? (im lactose & fm intolerant).

    Trying to heal my gut :( for good.

    Reply
  • Phyllis

    My gastroenterologist put me on a low residue, gluten and lactose free diet for IBS, SIBA, and diverticulosis. My RD suggested the FODMAP diet and it has really helped.However, no raw fruits or vegetables(per my dr) is extremely restrictive. May I gradually add them to my diet? I have stage 4 breast cancer with bone metastases so am worried about proper nutrition.

    Reply
    • katescarlata

      Phyllis, I can not provide individual dietary guidelines in a blog format. I would advise you to discuss your concerns with the health care team that is working with you.

      Best to you! And I am glad you feel better….

      Reply
    • Well Balanced - Food - Life - Travel

      I make my own chicken broth and not sure I have officially posted a recipe! Let me work on that one! I vary up my recipe but this is one variety: I add water to a large stock pot (about 8-10 cups),1-2 bone in chicken breast (about 1/2 pound each) some parsley, carrots, a celery stick, small lemon, peppercorns, a few scallion slices (green only), thyme and salt. Let it boil for 5 minutes and then simmer for about 30 minutes on medium-low heat. Turn off heat to and let the chicken slow cook for another hour and then strain broth-be careful it will still be warm. Use chicken to make chicken salad or other dish that suits you.

      Reply
  • Janet

    After suffering stomach pain, horrible gas, bloating, etc for two years, and undergoing every possible test the GI Dr could come up with at least once, most of them twice, I had a “medical assistant” suggest that I follow the FODMAP diet, by googling it. I did so (carefully) for 2 months, never adding dairy, and felt SOOO much better. So, I assume I have IBS. When the end of my 2 months came, I added only white bread/flour (1 serving on an occasional day), and nothing else. Then after several weeks of eating almost the same thing every day (not adding anything), I started getting the symptoms back again. I don’t have a dietician to help me, so I’m lost as to what to do next. It’s not only the days that I eat white flour, it’s every day, some days worse than others. Do I go back to wheat-free? Or where can I get the help I need? It was so nice to be symptom-free with my weight steady. Then I suddenly gained 3 lbs in one week…I guess from the bloating. Help!

    Reply
    • Well Balanced - Food - Life - Travel

      Janet, You could use the help of a dietitian that specializes in digestive health and nutrition. Can you try to find one in your local area? Where do you live? I can try to find you someone. Have you been tested for small intestinal bacterial overgrowth?

      Reply
  • Carolyn

    Hello Kate, I’ a huge fan of your website and follow a Fodmaps diet. Can’t find out anything about pumpkin though. Is it ok or hasn’t it been tested.

    Thanks again,
    Carolyn Harmer

    Reply
    • Well Balanced - Food - Life - Travel

      Carolyn, US pumpkin is undergoing testing. In the Australian info, ‘pumpkin’ often refers to what we would call in the US squash….so I sent them 4 cans of US pumpkin. I hope to learn soon if it is okay.

      Reply
  • Linda

    Hello Kate, I think I wrote this before but don’t think it posted. I was wondering if pickles (if bought from a farmer’s market so they are homemade with no added sugar or garlic) are low FODMAP? Thanks for whatever guidance you can provide, Linda

    Reply
    • Well Balanced - Food - Life - Travel

      Linda, I believe I responded to this–yes pickles without onion/garlic should be suitable.

      Reply
  • Shari

    Hi Kate,

    Absolutely love your website and blog, thank you!! My husband has been following the low FODMAP diet for 6 weeks now and feels so much better. We are waiting for our RD appointment set up by his gastroenterologist which is still 1 month away but he would like to start reintroducing some foods now. Wondering if you could suggest any foods that would be preferable to reintroduce first? I would like to choose wheat since that is one that would make cooking and eating a whole lot easier. Your thoughts?

    Thank you

    Reply
    • katescarlata

      Thanks Shari–glad you like my blog :) I typically don’t start with wheat first–but you could if you are truly missing it. I would start a ‘gentle’ wheat challenge by adding 1 slice of white sourdough bread while maintaining otherwise a low FODMAP diet. Then, if no symptoms–up to 2 slices of white sourdough bread on day #2. I encourage my clients to purchase a sourdough bread at Whole Foods or one with limited ingredients– only FODMAP friendly ingredients (besides the wheat). If on day 3–no symptoms he could try 3 slices at a sitting. Other wheat challenges that you could try Day #1 1/2 cup cooked pasta Day#2 1 cup cooked pasta Day#3 1 1/2 cup cooked pasta Wheat prepared with sourdough culture or white varieties seems easiest to re-introduce from my experience. Weight of bread can play a role too–if you eat a ‘heavy’ or dense roll for instance–by weight you would be eating more fructans–so opting for a light and airy bread may be better tolerated. Make sense?

      Reply
  • Judy

    I had rectal cancer surgery a year ago. The cancer was all removed as was a portion of my rectum. I have had bowel issues constipation and the loose stools since then. My doctor suggested trying a low FODMAP diet. Do you know of anyone else who has tried this with success? Thank You.

    Reply
    • katescarlata

      Hi Judy, Yes, I have has excellent luck with colon surgery patients and the low FODMAP diet. My major caution is that the low FODMAP diet lowers bifida bacteria populations which are linked with decreasing colon cancer risk–so the diet should be used short term–with the goal to try to get some of the fructans/GOS foods that increase these healthy gut bacteria population back into the diet.

      Reply
  • Katie

    I am having a hard time finding info on if balsalmic vinegar is low FODMAP. Can you assist me with this info?

    Reply
  • Fleur

    Hi Kate,
    Just have a question about making your own stock. If I use celery to make it but strain it would this be ok? I have seen other recipes that only use the leaves so I thought maybe the polyols might be water soluble and therefore not ok?

    Reply
  • tamara

    Hi Kate,

    I like to eat winter squash, but it can be hard for me to digest. Is acorn squash, spaghetti squash, and kobacha squash low FODMAP. Also what do you think about taking digestive enzymes?

    Thanks

    Reply
    • katescarlata

      Tamara–butternut squash has a fair amount of FODMAPs–both mannitol and GOS so needs to be limited to 1/4 cup, diced or less! not too much!
      I have not seen data on the other squashes. I think digestive enzymes are appropriate for some individuals who may actually be deficient in enzyme production–I don’t believe everyone w/ digestive health gets benefit from taking them.

      Reply
    • katescarlata

      SIBO testing is typically done in a hospital setting–big city hospital–not typically in the suburbs. But that seems to be changing as more hospitals are acquiring testing equipment. It might be done in a Gastroenterology Motility Lab or Department–if there is one. There are also home breath kits that you can use –but your health care provider would order it for you. Commonwealth labs is a Massachusetts based company- their test kits have been validated to some degree by Mark Pimentel–he compared results from Comm Lab kits vs. his equipment. http://hydrogenbreathtesting.com

      Reply
  • S

    Hi Kate,

    Just wondering if tahini is considered low fodmap? Some resources say no others say yes but i’m confused because sesame seeds are considered low FODMAP so surely something that is made from 100% sesame seeds should also be low FODMAP?

    Also, what do you think of this article? http://www.npr.org/blogs/thesalt/2014/04/28/306544406/got-gas-it-could-mean-you-ve-got-healthy-gut-microbes

    There is increasing evidence that foods high in FODMAPs actually prevent IBS symptoms rather than promote it by creating healthy bacteria necessary to digest these FODMAPs.

    Finally, is the Monash book more comprehensive than the iPhone application do you know? I find that the application is SO limited. For example, where would Barley Grass fall?

    Many thanks!

    Reply
  • Em

    Hi Kate,

    can you please advise on re-introduction of fodmaps where the main problem is constipation (followed by a day of frequency). Its hard to tell if the first sample of tested food has caused “symptoms” because of the time factor involved in constipation! So I never get past day one and learn nothing! Of course there is bloating too but again I am never sure how long after eating the “culprit” this would be expected to occur! I would so appreciate some guidance on these time factors, many thanks

    Reply
    • katescarlata

      How I do it: The test food should be added back once a day for three days. Get back to your baseline b/4 challenging a new food. Typically GI effects would be felt sometime during the day (w/ in 3-4 hours) of trialling –but constipation predominant patients are sometimes harder to read–and symptoms can take a bit longer.

      Reply
  • Alex

    I know beetroot is out but if something is made with beetroot powder for color is that out too or is there not enough to make a difference?

    Reply
  • Linda

    Hi, I just started the diet 2 days ago and I am learning to cook differently. Is coffee ok to drink and how about black teas like earl grey? Thanks. Linda

    Reply
    • katescarlata

      Coffee seems okay for most of my clients and is allowed in reasonable portion (1-2 cups). Black teas seem well tolerated too. Note that caffeine can stimulate the intestine to move–so adjust to your personal needs.

      Reply
  • Sue

    Hi,

    Are popcorn (homemade), soy sauce and corn syrup as a sweetener in food (not partially hydrogenated) allowed on the FODMAP diet? My 18-year-old son just started it and is already getting frustrated about the lack of snack options.

    Thanks so much

    Reply
    • katescarlata

      Sue, I allow popcorn but have not seen actual data on it. I know it has been included in some of Sue Shepherd’s books. Soy sauce is okay and as far as we know corn syrup is okay BUT not high fructose corn syrup.

      Reply
      • Sue

        Got it. HF corn syrup is evil. We cut it out of our diet years ago and my adult acne completely cleared. We live in the Boston area and my son is headed to BU in the fall, so we may contact you for an appt. Thanks so much for your quick reply.

  • Erin G

    Wow! You are remarkable! I have suffered with digestive issues since I was a teenager. Now, 17 years later I’m starting to make sense of it all. I am confused on bananas, though! How do I tell–from looking at the green/yellow exterior–when the banana is the safest to eat? How many are safe in a day? The online data is confusing and Monash calls them by two separate names. Something like sweet banana and common?
    Thanks again–You’re a Digestive Genius!

    Reply
    • katescarlata

      In the US, the banana in the app would refer to common banana. Ripe or unripe would be suitable on low FODMAP diet. Unripe has more starch and that can lead to gas in some people–depending on the nature and location of gut bacteria.

      Reply
  • Sue

    Hi again, Kate,

    My son’s SIBO test was inconclusive, but he started with a high hydrogen baseline and had pain after the test, so the GI prescribed Xifaxan (Pimentel protocol dosage). He’s been on a strict FODMAP diet for almost two weeks with mild improvement. As per Pimentel (from your blog!), I know he should cut down on that while on the antibiotic. But how much? Eat completely normally? Just add a few wheat products or onions?
    I hope you can advise as we have to wait a bit to see a nutritionist in person.

    Reply
    • katescarlata

      Hi Sue, I have not seen a definitive protocol…for liberalizing the diet. I tend to have my clients add small amounts of FODMAPs–1/2 an apple and some garlic and/or wheat to their day — I don’t want to fully exacerbate their symptoms but do want to have some ‘food’ for the microbes. More research is needed in this area!!

      Reply
  • Sue

    Thank you – you’re so generous with your time. You may be seeing my son in the fall, though I hope he’s better by then.

    Reply
  • christine gee

    Hi…I have just come across this website whilst trying to find some answers for treating gastritis. I have awful indigestion and at times, crippling stomach pains.
    I live in England and would love to contact a dietician about FODMAP but can’t seem to locate one. Doctors here just give tablets with no further advice. I have become so confused about the right foods to eat as some are suggested for gastritis and then totally banned on the FODMAP plan.
    I am completely confused and suffering badly…any help please?

    Reply
  • WG

    I really got a lot from your wonderful website and greatly appreciate the time you put into it. The Fodmap diet definitely helped with the gas and mild constipation that I experienced. My other problem is weak anal sphincters. Can this diet help the muscle tone over time, since there’s less irritation?

    Reply
  • Linda

    I have been on the Fodmap diet for about a month now. I felt better the first 2 weeks with much less gas and a calm stomach. The symptoms have returned these last 2 weeks though. Any thoughts why that is happening? I am also dairy free and I don’t eat meat or chicken so I may be eating too much of what it left. The diet is very restrictive and boring for me and now I feel that it is not helping. I appreciate any advice and insight. Thanks,
    Linda

    Reply
  • larissa clarke

    Hi – help!
    I have undergone numerous tests to find a cause for extreme constant bloating, nausea and lower abdominal griping pain plus upper stomach soreness and bloating. Everything has come back as normal (apart from mild gastritis).
    I had similar but lesser problems 8 years ago which went on for 3 years until it just went away for no obvious reason.
    I am (usually) a very fit active person running, triathlons etc but due to how rubbish I feel I have gained weight and lost my fitness. None of my clothes will do p and I look 6 months pregnant all of the time. I’m currently re-training to be a personal trainer and am now concerned this could affect my career. The gastroenterologist mentioned FODMAP but nothing further has come of it. Could I try without dietician support? Is it only for IBS or could it help with my sytmpoms? Apologies for long post. Thank you for any advice.

    Reply
    • katescarlata

      Larissa, the low FODMAP diet is evidenced based for use in the patient with IBS –but certainly may help individuals with bloating. I would check out King’s College London site to see if there is a dietitian to help you decipher your best dietary intervention. Additionally consider breath test for small intestinal bacterial overgrowth.

      Reply
  • Christine

    Hi Kate,

    Thank you so much for all the great information!
    I have to take an antihistamine against my allergy to pollen and in most of them is lactose monohydrate included. I am lactose intolerant, but the pharmacist told me that the amount is so small that it might not cause symptoms. I am not sure about that- I have different symptoms although I am on Fodmap.

    Is there a problem with it? Could you recommend an antihistamine without lactose monohydrate?

    Thank you so much!
    Christine

    Reply
  • Christine

    Hi Kate,

    I forgot to ask about the Fodmap content of Miso soup and Wasabi… Is Sushi safe to eat?

    Thanks,
    Christine

    Reply
  • Leona Barnett

    Just finished my antibiotic regimen for SIBO and am embarking on a Low FODMAP diet when I found your website. Very informative. My doctor suggested either SDC or Low FODMAP and based on a few hours of research on the internet, the Low FODMAP looks more appealing and something that I can easily manage into my lifestyle.
    I look forward to visiting your site frequently for updates and new ideas.
    Thank you!

    Reply
  • Carolyn

    Hi Kate,

    I am on a low fodmaps diet and am wondering about coconut. I enjoy both the milk and the flesh. Has it been tested for fodmaps and, if so, is it ok?

    Thank you for your help,

    Carolyn

    Reply
  • Louise

    Hi Kate,

    Thanks so much for the information! I’m new to this and still in the elimination phase. One thing I’m not clear on: if I can’t tolerate, say, a particular fructan does that mean I won’t be able to tolerate all other fructans? Or is it a question of how much, ie. is it possible I’ll be able to tolerate a food that’s lower in fructan?

    Also, what is it about almond milk?! I had a severe reaction to that, and yet almonds are not a fodmap food.

    thanks,

    Louise

    Reply
    • katescarlata

      Louise–tolerance to foods within the same group may vary–this is for a few reasons–some foods contain shorter or longer chain fructans, some foods in the ‘fructan group’ have more fructans than others, some foods might have fructans plus GOS in them–upping the total FODMAP load. So try different foods within the group before you say you can’t eat ANY fructans. I find many of my clients can tolerate a slice or two of sourdough white bread. Onion, on the other hand, is a bit more difficult for them–especially raw onion.
      Almond milk is likely high FODMAp–though we haven’t got a definitive on this yet–it’s still undergoing testing–is likely a big source of GOS and fructans. This is because almonds contain both fructans and GOS–they are allowed on the low FODMAP diet in a 10 almond limit… BUT when you make almond milk you add LOTS of almonds –then add water—and the fructans and GOS (which are water-soluble) can leach from the almonds right into the milk…then into your intestine…..and you know the rest of that story… Hope that helps! :)

      Reply
  • erin

    Hi Kate, Have you found one nut that is lowest fodmap and best-suited to make milk out of? I have been using walnuts to make milk. I’m vegan and am working to find a good alternative. I have seen rice milk listed as the best alternative but I struggle with SIBO issues, too.

    Reply
  • Heidi Hansen

    Thank you so much for all the info – my doc has told me to try this diet. I am going for a coeliac blood test in 2 days time, I stopped eating wheat on Sunday, should I still eat it until then for the test?
    Thank you

    Reply
    • katescarlata

      Yes, continue eating wheat until after the test. You may found you tolerate sourdough bread better–so try to stick w/ that–the sourdough can lower fructans (FODMAP source) but the gluten is still in the bread…or try 100% spelt bread which has the gluten but tends to be lower in FODMAPs as another alternative.

      Reply
    • Eileen

      Just realized that link may not have worked. The bars are by Bakery on Main SKU: 1131S
      Chocolate Almond Soft and Chewy Bars

      Reply
  • Palma

    Hi Kate,

    Thanks so much for all of the great information. I have suffered from digestive issues my entire life, chronic constipation, looking like I’m always six months pregnant and having a stomach ache every single day! Over the years I’ve tried so many natural/holistic approaches (homeopath, naturopath, colonics, traditional chinese medicine, every fibre supplement imaginable, dietary changes – gluten free, dairy free) with nothing really making a difference. Tired of the fight I went to see a GI specialist last week and he tested for Celiac disease. I’m glad to report that it’s not that, so he suspects IBS with constipation. He recommended taking Restoralax daily which I’m not comfortable with. He also suggested a new “pill” on the market I believe it’s constella, again not interested.

    The one great suggestion he made was to take a look at the low fodmap diet. I’ve done a bit of research and was quite overwhelmed with the discrepancies out there on various food items. Your lists and recipes are extremely helpful, so thank you so much!

    I have a dietician that I’ll be working with next week in the area (I’m from Toronto, Canada) so I’m hoping she can help as she is aware of the diet.

    I know that the diet is based on carbs so fat sources in moderation should be fine, but I found one site that listed margarine as a high fodmap source so I was a bit confused. Is there margarine with lactose in it maybe? Perhaps you could clarify. I checked my Earth Balance Soy Free spread and it states it’s lactose free.

    Thanks again! I’m excited to go shopping with my new list in tote. I imagine it’ll be a longer excursion than normal as I carefully read through every label!!

    Reply
  • Eileen

    I am confused about oatmeal/oats. I know it should be naturally gluten free however those with celiac and other disease are concerned about cross contamination. For those simply following low FODMAP, are all brands ok if ingredients are simply oats? What about granolas that list rolled oats?

    Thanks so much for all the advice.

    Reply
    • katescarlata

      Eileen–gluten free oats would be essential for a person with celiac disease but if ONLY following the low FODMAP diet–then you could use regular oats–the amount of wheat in cross contamination is not a problem for the low FOdMAP diet alone. Rolled oats would be okay for low FODMAP–but note–limit is 1/4 cup dry or 1/2 cup cooked.

      Reply
  • Meg

    Hi Kate!

    I had my first appointment with an RD concerning the low FODMAPs diet. I had one question she couldn’t answer so she directed me to you. I really enjoy uncured bacon, but since starting the low FODMAPs diet I have found that every package of uncured bacon lists celery powder as an ingredient in lieu of sodium nitrate. I have checked multiple stores and it is printed on every bacon label. Is celery powder OK to have? I typically only eat 2-3 strips of bacon at a time. I am currently on the elimination diet and will be starting reintroductions soon.

    Thanks for your help,
    Meg

    Reply
    • katescarlata

      Meg, Not sure that celery powder has been tested. I have seen celery powder added to bacon as well–the uncured varieties. I might try a piece and see if you note any symptoms. If no symptoms, try 2 another time.

      Reply
  • Maryse

    Hello Kate,

    My daughter started the low fodmap diet today (microscopic colitis with diarrhea as the only symptom) and I’m wondering about why it’s not healthy to stay on the diet long term. Is it because it prevents healthy bacteria from growing in the gut? Also, what are the most beneficial foods to reintroduce first to rebalance the body?
    Thanks so much!

    Reply
    • katescarlata

      Maryse, The low FODMAP diet has been shown to reduce some of the healthy bacteria in our intestine. We don’t know what this means for our long term health…much more research is needed!! The fructans and GOS increase these healthy bacteria–so perhaps trying to add back small amounts of food choices with these FODMAP sources will be the long term goal. The science of diet and our gut bacteria populations is exploding now–but still very much in its infancy.

      Reply
  • Nicole

    Hi, I’m debating trying this diet on my own, to see if I can get relief from my symptoms, but I will be doing it solo, as there is no one around me well versed in the FODMAP diet. I was wondering, the moderate fructans and GOS that are allowed, can they be included during the elimination phase? I know my IBS (self diagnosed), is anxiety related, so wondering if this diet will help or should I not bother until I see someone regarding the anxiety? Thanks for any advice.

    Reply
    • katescarlata

      Nicole, My recommendation is to NEVER self diagnose. Seek medical assistance. You don’t want to miss something that could warrant medical treatment or other dietary modifications–such as celiac disease or inflammatory bowel disease.

      Reply
  • Rachel Hamilton

    Hi Kate,

    I was just on the Quest website. I’m wondering if you think the protein bars are ok on the low FODMAP diet? I just found them and they don’t seem to have any high FODMAP ingredients(http://www.questnutrition.com/protein-bars/)…Also they have protein chips which seem ok-they have milk protein isolate but I think when it’s protein isolate it’s ok? Would love your feedback on this as I’m finding the low FODMAP diet a very carb-heavy one-I would really like a safe protein snack!
    The ingredients of the chips are below:
    INGREDIENTS: Protein Blend (Milk Protein Isolate, Whey Protein Isolate), Dried Potatoes, Corn Starch, High Oleic Sunflower Oil. Contains less than 2% of the following: Sea Salt, Calcium Carbonate, Natural Flavors. CONTAINS: Milk Derived Ingredients.

    Reply
    • katescarlata

      Hi Rachel, First of all—do you best to stick w/ real foods vs. products. Many real foods in their natural state have been tested for FODMAP content–not too many products–so it’s hard to know for sure about various bars etc. Occasionally grabbing a bar on the run–is okay–but wouldn’t make them my main stay. Ingredients wise the bars don’t seem too bad –but I am not a fan of sucralose–and they add it.
      The chips seem okay. Calcium carbonate can be constipating though–not sure why they add it. Safe protein rich snacks: Cheddar cheese chunks, peanut butter, a hard cooked egg, lactose free yogurt, handful of lower FODMAP nuts.

      Reply
  • Jen

    Also, I’m wondering about tomatoes. They are on the Low list but I see some posts here about people limiting them. Are they ok, or limited? What about tomato sauce and purees?

    Reply
  • Beth

    Kate,
    Thank you for putting all of this info into one place!
    Following is the ingredient list for Earth Balance’s Original spread:

    Natural oil blend (palm fruit, canola, soybean, flax, and olive oils), filtered water, contains less than 2% of pure salt, natural flavor (plant derived from corn, no MSG, no alcohol, no gluten), pea protein, sunflower lecithin, lactic acid (non-dairy), and naturally extracted annatto for color.

    Is there any ingredient in here that gives you pause in regards to FODMAP?
    Thank you,
    Beth

    Reply
    • katescarlata

      Beth, I don’t know too much about pea protein. It’s probably okay–but that would be the one ingredients I would question. I have had clients use Earth Balance products, however, without an issue.

      Reply
  • Beth

    I don’t suspect I’m having an issue, but with being new to FODMAP I thought it would be prudent to ask. :)
    I was just looking through some of your recipes. The breakfast bar recipe made with the Mesa Sunrise cereal contains corn syrup, yet corn syrup is listed as high. Could you please clarify whether it’s okay to use or not?
    Thank you!

    Reply
    • katescarlata

      Corn syrup is a grey area. High fructose corn syrup is a definite NO…but plain corn syrup likely varies from one brand to the other. There are many products with regular corn syrup in the US and many of these are well tolerated. I allow the Mesa Sunrise cereal.

      Reply
  • Beth

    I was mistaken–it was in the comments section of the breakfast bar recipe where you suggested someone use a little bit of corn syrup to thicken up the peanut butter in lieu of marshmallows (I hope I got this right this time!).
    Thank you, though, for clarifying about the corn syrup. It means I can have an occasional fun-size Snickers bar and not worry. : )

    Reply
  • Mary

    Is Turbinado sugar allowed (evaporated cane sugar)?
    What can one take with a sore throat since they all seem to have high fodmap sweeteners?
    Can we eat meats like ham, bacon, and salami or is the curing/smoking process a problem?
    Should we consider all dried fruits off limits during elimination phase? raisins, craisins, apricots..?

    Reply
    • katescarlata

      Turbinado sugar should be okay. Ricola looks okay for sore throat– the lemon mint variety–it does contains some herbals though –which I don’t really know too much about! Curing and smoking should not pose a problem as far as I know from FODMAP perspective–but I recommend these sometimes higher fat/salt foods as an occasional treat rather than a daily food. I allow small amounts of raisins and dried cranberries (1 tablespoon per serving) as outline in the fabulous Monash app.

      Reply
  • Em

    hi Kate, I am fructose intolerant and have a question about sucrose please. I know it is half fructose so should it be limited to 6g at a sitting to meet the recommended 3g fructose limit imposed on fruit etc? And if I have a piece of low fodmap fruit should anything containing sucrose also be excluded at that meal? (I have a sweet tooth & don’t want sucrose to unwittingly be my downfall).
    Many thanks as ever.

    Reply
  • Melinda Sullivan

    Hi, I too am wondering about the fructose content in table sugar, are raw sugar, white sugar, caster sugar all the same in fructose content?

    Also my dietician told me I could use agave syrup and coconut flower nectar but as far as I know they are both quite high in fructose?

    I have had Lactose intolerance ruled out, from an endoscopy but do I still need to beware of this for another reason in the elimination stage of this diet

    Thank you for your great website, Melinda

    Reply
    • katescarlata

      Melinda–table sugar has an even amount of fructose and glucose. Glucose helps fructose absorption–so when fructose and glucose are present in equal amounts OR when the glucose content is greater than the fructose content–those foods should be well tolerated and low FODMAP from fructose perspective. BUT everyone has their own person fructose load threshold. SO –choose foods that don’t have excess fructose BUT also be sure to limit to one serving of these fructose containing foods per meal. One banana OR one orange for instance would be a good serving–avoid eating a large fruit salad the size of your head, for instance. :) If you use table sugar–white sugar, raw sugar….keep the portion reasonable. 1-2 TB max would be a good limit. And yes, avoid coconut nectar and agave!!

      Reply
  • Nick

    Hi! Yet to find a better FODMAPS resource online (including Monash’s own site), so thankyou so much. Early days yet but hopeful.

    Just need to ask: do you know if bitter gourd are low/no FODMAPS?

    Cheeeeeeeeeeeeers :) N

    Reply
  • Rose Wilkinson

    I am still getting to grips with this program. Can anyone tell me 1) how long you need to be on the basic FODMAP and 2) once you start migrating foods back do you do one at a time and for how long?
    Rose

    Reply
  • Robert

    Kate – so I have been trying the ‘elimination’ diet for about 8 weeks now and feel much better overall. Just for clarification, the elimination diet is a low-fodmap diet, not a no-fodmap diet, correct? I’m confused about the differences between those terms. I still have relatively mild symptoms at times but I think it is the result more of too large portion sizes of low-fodmap foods but figured I’d check in case I was wrong on this. Thanks!

    Reply
  • Dawn Halstead

    I have recently been dx’d w/SIBO, about 1 week ago. I have been trying to follow the SCD diet but the initial stage or juice, mashed bananas and juice, still cause bloating and reflux and I still have diarrhea. I’m wondering if the FODMap would be a better way to go? Plus, the article you posted about the SIBO symposium, even suggests not changing my normal diet until I’m finished w/the antibiotics. I’ve spent days and hours researching and am so confused and disheartened. I have lost 7 lbs in the last 2 weeks and cannot lose anymore. I have been making all of my own food, including yogurt and broth. I live in Des Moines, IA, and my GI, tho being thorough and even re-running blood tests for malnutrition and thyroid again this morn do not mention diet. I have been sick since August, when we came home from England early. Dx’d back home w/diverticulitis, and just as I was regaining weight, caught a virus that went into a sinus infection, requiring more antibiotics. Now this SIBO. I also have a very low IgG level that is being followed by a hematologist. I just don’t know which way to go for diet or further follow up. Thank you.

    Reply
  • Em

    Quick question on re-introducing polyols please Kate. Are dried apricots a good test only I see they contain oligo fructans as well as polyols? Many thanks.

    Reply
    • katescarlata

      Em, they do contain fructans though..I am not sure exactly how much. 2 dried apricots have moderate fructans and higher amounts of sorbitol. Blackberries might be a better bet for testing to do a more pure test. Food is complex–fiber content is variable and other factors can play a role. I do use both apricots and blackberries for a sorbitol challenge –but as I mentioned–blackberries would be best.

      Reply
  • tomasz

    I have been on fodmap and it’s tough but getting better. I am having trouble with finding a protein supplement I can drink to get extra protein. They all have so many bad ingredients. I am lactose and fructose intolerant which makes it even harder. Is pea protein safe? and I have heard whey protein isolate could be lactose free as well?
    Any feedback would be helpful!

    Reply
  • Jane

    Hi, I have just started the low FODMAP diet as my GP thinks I have IBS. I have been eating only low FODMAP foods for a week but my symptoms are no better and I have a headache most of the time. Is this common?
    I had heard that you can feel worse before you feel better ?
    Also, I am making my own bread with Spelt flour – is that ok on this diet?

    Reply
    • katescarlata

      Jane, I would work with a dietitian to sort out why you might be getting headaches on the diet. This is not a frequent problem I find in my practice. Some people do feel worse on the diet at first–but this is very rare in my practice. There are numerous reasons you may be getting headaches–but this would be best sorted out with a health professional!!

      Reply
  • Jul

    Hi Kate,

    I have never been a big drinker but do miss having the occasional wheat beer or glass of wine (fructose and fructans are issues for me and I’ve been restricting these as I get my symptoms under control). I note that wine and beer are considered low-FODMAP. Would that still be the case for wheat beers? Or beers that have honey or molasses as an ingredient?

    Also, I know that certain wines can be higher in fructose – do you suggest any types of wine that are easier on the stomach?

    Thank you!

    Reply
  • Lillian Butler

    I have been dealing with IBS for nearly 40 years. My physician put me probiotics about eight years ago, on a gluten free diet about two years ago, and added low residue restrictions about eight months ago. He now wants me to add low fodmap restrictions. HELP! I have been trying to cross reference everything to see what I can actually eat. I am in North Alabama. Do you know of someone here that can walk me through this or are you able to do that from MA? Please let me know. Thanks.

    Reply
    • katescarlata

      Ali, I believe probiotics should be selected on evidenced based research and the patients symptoms. For my constipation patients–I like align for starters….for those who experience diarrhea–I find Culturelle–health and wellness formula works well. VSL#3 works for some —particularly if bloating is presenting symptom–starting at very low dose. BUT it is best to discuss your probiotic needs with a health professional that is aware of your medical history. Those with active small intestinal bacterial overgrowth–probiotics may be contraindicated–more research is needed in this population!

      Reply
  • Valerie

    Hi Kate,

    Thank you for all the information, your blog is such a helpful resource! I love and appreciate all the downloadable PDF resource guides you offer!

    I have a question about drink mixes, I typically only drink water, but that gets old very fast. I was wondering if there are any calorie free drink mixes that might be safe to use? In particular I was hoping to get your input on this one:
    http://www.amazinggrass.com/store/green-superfood-original.html

    Or if you have any that you recommend?

    Thanks in advance!
    Valerie

    Reply
    • katescarlata

      Due to time constraints…I get 100s of emails per day–plus many blog comments–it’s impossible to answer ALL of the questions regarding many products. I wish I had more time..but lately…I simply don’t :( So…if you have the food product ingredients–and you list them in a comment–and keep to one or two foods, I am may be more likely to respond. As the FODMAP concept emerges–more and more people are coming to my blog and find my email…and I WISH I could answer all the VERY important question you have!! Bottomline: list ingredients vs. sending a link–it saves time and I might be able to respond!

      Reply
      • Valerie

        The ingredient list is quick hefty since this is a superfood drink mix and contains all kinds of vitamins/minerals. Since I don’t feel inclined to list all the ingredients as it might take some time, could you provide any recommendations on any calorie free drink mixes you use?

        Thanks in advance

  • Alex

    Hi Kate,
    What is your opinion on the following protein powders? I’m vegan and struggling meet protein needs with foods that are not soya based and have a complete and adequate amino acid profile. I have found sun warrior blends are quite good, but not sure about some of the ingredients.
    Warrior Blend Natural http://www.sunwarrior.com/store/warrior-blend-natural-500g.html
    Warrior Blend Vanilla http://www.sunwarrior.com/store/warrior-blend-vanilla-500g.html
    Classic Natural http://www.sunwarrior.com/store/proteins-natural-500g.html
    Classic Vanilla http://www.sunwarrior.com/store/vanilla-protein-500g.html

    EVER SO THANK YOU TO HELP ALL OF US IN UNDERSTANDING MORE ABOUT LIFE ON FODMAPS!!

    Best,
    Alex

    Reply
  • Alex

    Hi Kate,
    This is the list for sunwarrior protein powder:

    1. Classic Vanilla: Raw Whole Grain Brown Rice Protein, Rice Oligodextrin, Vanilla Extract, Stevia, Xanthan Gum, Ancient Sea Salt, Pectin

    2. Classic Natural: Raw Whole Grain Brown Rice Protein
    Warrior Blend Vanilla: Proprietary Protein Blend (Raw Organic Pea Protein, Raw Cranberry Protein, Raw Organic Hemp Seed Protein),Organic Vanilla Extract, Natural Fibers (Fenugreek, Konjac), Stevia, Ancient Sea Salt, Medium Chain Triglycerides from Coconut, Herbal (Tea Leaf) Extract, Natural Citrus Extract, Organic Cinnamon Extract

    3. Warrior Blend Vanilla: Proprietary Protein Blend (Raw Organic Pea Protein, Raw Cranberry Protein, Raw Organic Hemp Seed Protein),Organic Vanilla Extract, Natural Fibers (Fenugreek, Konjac), Stevia, Ancient Sea Salt, Medium Chain Triglycerides from Coconut, Herbal (Tea Leaf) Extract, Natural Citrus Extract, Organic Cinnamon Extract

    4. Warrior Blend Natural: Proprietary Protein Blend (Raw Organic Pea Protein, Raw Cranberry Protein, Raw Organic Hemp Seed Protein), Medium Chain Triglycerides from Coconut

    THANK YOU SO SO SO SO MUCH FOR TAKING THE TIME TO HELP US ALL IN THIS FODMAP JOURNEY!! You really are on of a kind. I find dietitians here in the UK are very jealous and selfish about sharing information for free.

    Warmest wishes,
    Alex

    Reply
    • katescarlata

      Alex,The first one looks okay–but pectin and gums can be ‘gassy’ though not FODMAPs. I like the classic Sun Warrior protein powder. Not sure about the pea protein in the other options–especially as a primary ingredient. I have had client try Go Macro bars with pea protein and tolerate it fine–but not sure if the amount in the powder would up potential FODMAPs–just don’t know. I do have protein powders–including the classic Sun Warrior on my Pinterest board. Check it out here: https://www.pinterest.com/katescarlta/your-fodmap-kitchen/

      Reply
      • Alex

        Hi Kate,

        Thank you for taking the time to answer. I appreciate it a lot. Will check you Pinterest as well.

        Have a fab day,
        Alex

  • Nicole

    Hi Kate, how soon would I expect a reaction from eating a med/high FODMAP food? After following a low FODMAP diet for a couple of years, I now tolerate many FODMAPs fairly well and rarely suffer with bloating or diarrhoea like I used to before starting the diet. However I do frequently suffer with IBS-like cramps perhaps 1 hour after a ‘normal to loose’ but regular (1 to 1 1/2 days) BM. The pain is mild but can last on average for a couple of hours, then I feel OK. Does this sound FODMAP related and why does the pain happen then and not within hours of eating? Any insight from you would be much appreciated, thank you, as I cannot seem to find anything to explain this anywhere else.

    Reply
      • Nicole

        Thanks so much for getting back to me so quickly, I’m very grateful. Is there anything I can take/do to relieve the bowel spasm? Do you think it sound FODMAP-related?

  • Paula

    I am confused as to whether the following are FODMAP friendly or not:

    whey protein isolate
    kale
    lettuce (as some websites say it is not ok)
    edamame
    apple cider vinegar
    stevia

    You’re website is great and I have the Monash app but some things are not on there.

    Reply
  • Paula

    Are these FODMAP safe:

    edamame
    whey protein isolate
    apple cider vinegar
    stevia
    kale
    all forms of lettuce (some websites say this is not ok)

    Thanks

    Reply
    • katescarlata

      Edamame would have FODMAPs–it’s whole soybean, Whey protein isolate–would be okay, low FODMAP. Apple cider vinegar–distilled–should be okay–but would limit to 1 TB max–have not seen data from Monash on it, Stevia is low FODMAP, Kale is low FODMAP, not all lettuce has been tested–I find my clients tolerate baby greens best–baby lettuce, arugula, butter lettuce.

      Reply
  • Rod

    Hi Kate,

    Thanks for this amazing site!

    I have had colitis for 5 years with daily diarrhea and just started the low FODMAP diet. I have read that insoluble fibre is generally bad for ulcerative colitis. There are many low FODMAP foods that are high in insoluble fibre such as spinach, collard greens, kale, lettuce, bell peppers, bok choy, eggplant, tomatoes, green beans, raspberries and strawberries.

    What do you recommend?

    Reply
    • katescarlata

      Hi Rod, Depends on if the patient w/ UC is having active flare…insoluble fiber tolerance varies person to person. So, I really work individually with the patient and modify insoluble fiber depending on what is going on. I encourage you to work with a dietitian knowledgeable with IBD and nutrition care.

      Reply
    • katescarlata

      Hi Sara,
      Tomatoes are low FODMAP but when you concentrate them and cook them down –say in tomato paste–the fructose content concentrates and tomato paste can be a source of excess fructose….small amounts such as 1 tablespoon should be okay–but not large amounts.

      Reply
  • Alex

    Dear Kate,

    As always, thank you for always having the time to reply to all our questions.

    1. I’m lactose intolerant, I was tolerating well authentic greek yogurt. I’ve been told to come off cow’s dairy because of inflammation and relation to auto immune diseases. I’m also lactose intolerant. I am allowed sheep and goat’s dairy, but I’m not sure about the lactose content. What’s your opinion on it?

    2. What’s your opinion on the following UDO’s choice supplements:

    a) Super 8 High Count Probiotic:

    Lactobacillus acidophilus (HA-122) : 45%
    Lactobacillus rhamnosus (HA-111) : 25%
    Lactobacillus rhamnosus (HA-114) : 10%
    Lactobacillus plantarum (HA-119) : 7%
    Bifidobacterium bifidum (HA-132) : 6%
    Lactobacillus casei (HA-108) : 3%
    Bifidobacterium longum (HA-135) : 3%
    Lactobacillus salivarius (HA-118) : 1%

    b) Digestive Enzimes:

    Alpha-amylase 5000 DU (62.5mg)
    Lactase 3000 ALU (37.5mg)
    Alpha-galactosidase 260 GalU (29.9mg)
    Protease 12500 HUT (25mg)
    Cellulase 400 CU (11.5mg)
    Lipase 150 LU (8.6mg)
    Stem bromelain 50000 PU (1.7mg)

    c) Beyond Greens Powder ( I guess it’s a no no…):

    – Greens: Barley, Alfalfa, Oat and Rye Grass powders, Chlorella, Spirulina.
    Defatted seed and fibre: Brown flax seed, sesame seed, sunflower seed, oat bran, rice bran, golden flax seed (whole), psyllium husk.
    – Food Concentrates: Carrot, Soyforce™ powdered sprouted soybeans, tomato, beet powder, broccoli, kale, parsley, Udo’s Choice Ultimate Digestive Enzyme Blend powder (amylase, lipase, protease, cellulase, glucoamylase, invertase, malt diastase, lactase, pectinase (with phytase) and bromelain in a base of beet root fibre.
    – Phytonutrients blend: Cinnamon bark, ginger root, peppermint leaf, bilberry leaf, licorice root, red clover blossom, lemongrass, artichoke leaf, dandelion root and leaf, rosemary leaf, thyme herb, standardized grape seed extract.

    Many many many thanks,
    Alex

    Reply
  • Alex

    Alex here again…

    The reason why I ask about the sheep and goat’s yogurt, is because I read in some other blog (brand for sheep’s yogurt) that people with lactose intolerance DO tolerate sheep’s yogurt because apparently the lactose has been broken already. It seems to me more marketing that other thing. However, when comparing carbs content from goat’s to sheep, sheep does have less carbs than goat’s.

    This is what I found:

    “FACT 6
    The lactose. Even if people are severely lactose intolerant, the lactose will have been converted into lactic acid if they take their sheep milk in the form of yoghurt and much of the lactose goes out with the whey in hard cheese making. There is also evidence that the lactose in sheep milk is more tolerated than from other milk and certainly worth a try.
    Remember that any illness or any cause for the use of antibiotics reduces your immune system, however wonderful antibiotics may be, they usually kill the good bugs along with the bad. Yoghurt, especially Acidolphus yoghurt, helps to redress this and restore the gut flora back to its original load, all working to prevent”
    http://www.sheepcentre.co.uk/sheep_milk_facts.htm

    Thanks so much again.
    Alex

    Reply
  • Anne

    Hi Kate,

    What brand of coconut milk do you recommend? I notice the carton varieties have additives like guar gum and I was wondering if that could be problematic for IBS.

    Thanks.
    Anne

    Reply
  • Robbieann

    HI, getting really confused about brown rice and 1-2 Tbsp a day of fresh ground flax seed, have IBS symptoms and definitely cut out wheat, sugars etc. and symptoms start to get better but have used flax seed for numerous yrs.(keeps things regular) and have never eaten much rice but running out of foods to eat. All these “lists” say different things. Any thoughts ?

    Reply
  • Michelle

    I have been in denial for years that I have IBS but I am ready to get out of pain so I want to follow the diet precisely. I am a big cold press juicer. What herbs are we allowed to have. I saw ginger but can we have anything else like turmeric, mint, basil etc? Also, is there any difference with juicing foods vs eating them. I would love to have apples in my juice….fingers crossed. Also, you did not list almond milk, is this a no, no? Any suggestions on alcohol?
    Thanks for this site. Love the clear and concise way it is laid out!

    Reply
  • Margaret VanDyke

    Your blog and website are life savers. Thank you!! Big problem with following FODMAP diet is being hypoglycemic and needing to have snacks in my purse. Many bars that are 90% good (no FODMAPS) will have dates, agave,or inulin from Chicory root. Since these would be in low percentages are they ok or am I sabotaging myself? So appreciate an answer to this!!

    Reply
  • Margaret VanDyke

    Thank you. Not wanting to be a pest but you are my only resource as the gastro doc is almost inaccessible. I have excema on my legs and to a lesser extent in small areas on my arms or torso. It has become excruciating at night preventing sleep with the itching and burning. I have always had very good skin with no problems. Is this possibly from the SIBO? Also can the bacteria overgrowth affect the bladder? I keep getting UTIs that are very resistent to antibiotics and just won’t clear up. I hate to keep asking for your valuable time, but I am really suffering. Thank you from my heart.

    Reply
  • Jillian

    Hi Kate! I have been following the FODMAP diet for a few weeks now, and the difference is amazing! I accidentally ate something with garlic and onion in it the other day (didn’t know until after I ate that it was in there) and my IBS symptoms came back full force. If I’m intolerant to garlic and onion, would that mean I am intolerant to all fructans? Or do you test different types of fructans (wheat, fruits, etc) separately after the elimination phase? Thanks in advance for your help!

    Reply
    • katescarlata

      Jillian, definitely try different foods from the fructan group to assess your tolerance. I typically test my clients tolerance to fructans with onion, garlic AND sourdough bread. Then if sourdough works okay–I might try regular wheat bread.

      Reply
  • Margaret VanDyke

    I have not seen a reply to my question above about excema and UTIs, but I know there are replies in different places. Have I missed it?

    Reply
    • katescarlata

      Perhaps I missed it, Margaret. Not sure if I can answer a question about UTIs–but feel free to repost. I try to get to most questions–but can’t possibly get to all of them.

      Reply
  • Margaret VanDyke

    Basically the question that got missed was if SIBO can cause persistent UTI’s and/or exceed. (I have both and do have SIBO) Other important question:are maltodextrin and tamarin/soy sauce allowed? I have seen it both ways and they are in something I can otherwise eat and like. (Master crunch gluten free crackers)
    Thank you again, Kate.

    Reply
  • Margaret VanDyke

    Thank you Kate. Can you tell me if Tamari and soy sauce are ok? Also maltodextrin. They are both in Mastercrunch gluten free crackers which are delicious but those ingredients concern me. Hope you can answer this. you are a real life saver.

    Reply
  • Margaret VanDyke

    Is Coconut Palm Sugar ok? There is an amazingly good cereal made from sprouted rice called Veganic Sprouted Rice Cocao Crisps that is sweetened with it.
    Otherwise I think it is a perfect food for Fodmapers…. delicious with lactose free milk. Another one Maple Buckwheat Flakes that does have a bit of honey (last ingredient) and that I seem to tolerate. Wanted to pass on the good news.

    Reply
  • margaet gurney

    Hi Kate,

    Can you explain how to do the reintroduction of food on the low fodmap diet. Do you do individual foods or food groups. Do you break it up into l food a week or 1 every few days. How can you tell if you are having a reaction to one food when you try another, especially if there is no time in between? I can’t find any detailed information as to how to do this properly. I am going to a dietician soon but don’t know if she has experience with low fodmap. Thank you.

    Reply
    • katescarlata

      Tami, likely it would be a FODMAP source–but it doesn’t seem to bother my clients. Might avoid initially while on low FODMAP diet–and then introduce to assess better if it causes any symptoms.

      Reply
    • katescarlata

      Black beans have not been tested as far as I know. Canned chickpeas, drained and rinsed (1/4 cup) and canned lentils, drained and rinsed (1/2 cup) are considered low enough in FODMAPs.

      Reply
  • Jul

    Hi Kate,
    My tests for SIBO and fructose malabsorption both came back negative, despite my symptoms indicating that those issues were highly likely. I had a high hydrogen baseline both times, which my doctor said could either indicate a slip-up in preparation for the test (but I ate only plain chicken and white rice) or could actually indicate SIBO. She suggested treating experimentally for SIBO. In related news, I just had an endoscopy to check for celiac disease because my symptoms came back severely when I did a 6-week gluten challenge after a year gluten-free. The biopsies were negative for celiac but my doctor found that I have gastritis and peptic duodenitis. She thinks it is caused by an overproduction of stomach acid; I was negative for h pylori. She put me on Nexium and back on the gluten-free and low FODMAP diet. So far the Nexium seems to actually worsen my symptoms. My questions are:
    (1) Have you heard of high baseline hydrogen indicating SIBO?
    (2) If a patient has SIBO, wouldn’t that include an under-production of stomach acid rather than over-production (making Nexium counterproductive)?
    (3) Can SIBO cause gastritis and duodenitis?
    Thank you !!!

    Reply
    • katescarlata

      I do see baseline high hydrogen on SIBO test results occasionally. It is often thought to be due to poor prep for the test….but my patients feel they prepped adequately—so not sure if poor prep is always the cause of a high baseline hydrogen. Some bacteria can cause inflammation–so yes, I believe, you can present with inflammation in SIBO. It could be that the Nexium is not the solution for you and exacerbating your symptoms. Sorry in the delay in getting back to you.

      Reply
  • Margaret VanDyke

    Hi Kate, I’ve just undergone a barium Xray and fluoroscope , breath test, gastric emptying test and another I’ve forgotten. Dr. keeps saying “negative” but has finally given me Rifaxim. My question: he prescribes TWICE a day, while Dr. Pimental suggests Three Times a Day according to your article. I’m worried about this. What are your thoughts? Also: his nurse said “it’s ok” to take probiotics while on the antibiotic. I feel dubious about this. Seems counterproductive. Please give me your input as you are the only “real expert” I can ask. Thank you from my heart!

    Reply
    • katescarlata

      Some docs prescribe the rifaximin twice a day. I do find in my practice that the twice a day works for some–but not all. I think three times per day is the general rule and it works better. I do not recommend probiotics until I know the SIBO is eradicated.

      Reply
  • Margaret VanDyke

    Thank you, Kate. You are invaluable to me. I finished the course of rifaximin at 2X a day and think it probably worked. (??) I didn’t take the probiotics even though the dr.’s office told me I should/could. That’s the problem for so many of us: doctors who really don’t know enough about SIBO! My question now is should I start taking probiotics since I’m off the rifaximin? I think I’ve seen where you are not convinced they are good for the SIBO prone. Should I start with low dose? I have the VSL3 very potent ones and also some with fewer strains from ReNew Life. I really appreciate your guidance on this as I am desperate to stay SIBO free!!!!

    Reply
    • katescarlata

      Yes, Angelo–individuals with Crohn’s disease have higher incidence of fructose malabsorption—I find the diet works very well for many with IBD—to help with overlapping IBS symptoms.

      Reply

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