Not sure if fermented foods would be helpful or detrimental. I think that might vary person to person–depending on the motility of the small intestine and number of cleansing waves and their current gut microbiota. Brown rice was shown to only have a trace of fructans so think it is okay and low FODMAP. Also –consider small intestinal bacterial overgrowth as a co-existing diagnosis. Note FODMAPs draw water into the intestine–so even if they are NOT malabsorbed –they can still trigger symptoms in individuals with a sensitive gut. So see how she tolerates lactose containing foods such as yogurt. Cheese especially hard cheeses have minimal lactose so should be okay from a FODMAP standpoint.

Appreciate any help you can provide. I am a food scientist, so even directing me to experts on the subject would be helpful. We don’t have any MD’s or RD’s with expertise on FM in our area, that I know of, so I am researching through the internet for information to help my daughter.

Kriss-
Are you working with a dietitian? She/he can assess if your husband is getting enough fiber or following the diet in an appropriate manner. It does take longer from my experience for those with IBS-C to get benefit from the diet–but certainly by 6 weeks most people either can determine that they are making progress or not. Not sure what you mean by fodmap free? When you go on the diet–you try your best to avoid all high FODMAP foods and to keep the ‘moderate’ FODMAP food to limits as described on my check list. If you husband is not having regular BMs at this point–I would discuss with his gastroenterologist what an appropriate bowel regimen would be. Assessing for other issues that may be contributing to his symptoms with his GI doctor such as small intestinal bacterial overgrowth (particularly check methane levels), motility issue that might require medicine to help manage, etc.

Thanks Kate!! Great information about the ATI’s too-Thx for sharing!

Hi EA–there was some discussion and research abstracts that discussed fatigue/depression in NCGS induced from gluten. There was discussions regarding migraines and other systemic symptoms due potentially from gluten in NCGS. BUT there remains controversy around the NCGS diagnosis in the sense that although it likely exists perhaps in a much smaller cohort of people than previously thought. That FODMAP sensitivity likely outnumbers gluten sensitivity-in regard to GI symptoms. More research in the area of amylase trypsin inhibitors (ATIs), gut microbiome alterations may help us further understand NCGS or provide insight into some of the systemic impact shown. ATIs are pest resistant molecules of grains (found in gluten containing grains/cereals) and seem to activate innate immune response in celiac disease and perhaps in NCGS. ATIs shown to exacerbate symptoms of multiple sclerosis. GREAT conference that provided more questions than answers (for me) but progression of our understanding of NCGS.

Your most welcome Ron. You could undergo more of a gluten challenge vs. a fructan challenge. Working with a dietitian to help you with this–of course. Vanilla extract should not pose a problem–and I allow it with my clients.

Julia….We should know about US pumpkin by Thanksgiving. It is undergoing testing at this time. I sent 4 different canned pumpkin products myself…so I know we will have the info soon enough!