Looking for information on the FODMAP diet by NHS in the UK? Through this post, we will try to explain to you what the FODMAP diet recommended for IBS (Irritable Bowel Syndrome) is and why the Low FODMAP diet is advised. Let’s have a look at IBS in detail here:
What is Irritable Bowel Syndrome?
IBS or Irritable Bowel Syndrome is a group of symptoms that occur together. These include:
- Pain in abdomen
- Diarrhoea
- Constipation
Other symptoms such as bloating, stomach cramps, change in frequency of stool, or change in form of the stool are often associated with IBS.
Diagnosis Criteria
Rome V criteria is used for diagnosis of IBS which is as follows:
- Duration
- Persistent symptoms >_3 months with
- Symptoms onset of at least 6 months
- Persistent symptoms >_3 months with
- Frequency
- >_1 day per week
- Symptoms
- Recurrent abdominal pain with at least 2 of the following
- Related to Defaecation
- Change in Frequency of Stool
- Change in Form of Stool
- Recurrent abdominal pain with at least 2 of the following
Red Flag Features (need for investigation of cancer)
- Rectal bleeding
- Unexplained/ unintentional weight loss
- Family History of bowel/ ovarian cancer
- Onset after 60 years of age
Causes
IBS is attributed to unknown aetiology. This simply means the cause of IBS is unknown for now. However, it’s been linked gut mobility, nerve sensitivity in gut, stress and a positive family history.
Investigations
The following are the investigations done for IBS:
- No diagnostic test for IBS
- FBC, ESR/CRP
- IgA TTG for Celiac
- Faecal calprotectin for IBD
- Faecal immunochemical test (FIT) for colon cancer
- Ca-125 for ovarian cancer
A positive diagnosis should be made if the patient has abdominal pain relieved by defaecation or associated with altered bowel frequency +/- stool form in addition to 2 of the following symptoms-
- Altered stool passage (straining, urgency incomplete evacuation)
- Abdominal bloating (women>men), distension, tension or hardness
- Symptoms worse by eating, relieved by defaecation
- Passage of mucus
Types
- IBS-C (Constipation predominant)
- IBS-D (Diarrhoea predominant)
- IBS-M (Mixed)
Management
Sadly, there is no cure for IBS yet. However, positive lifestyle changes are reinforced for management of IBS:
- Low FODMAP diet
- Antispasmodics- e.g. mebeverine, peppermint oil
- Laxative- Ispaghula husk for IBS-C
- Anti-diarrhoeal- Loperamide for IBS-D
FODMAP Diet NHS
NHS recommends low FODMAP diet. Let’s learn more about what is FODMAP diet:
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols are short chain carbohydrates that are poorly absorbed in small intestine and are prone to absorb water and ferment in the colon.
High FODMAP Diet NHS
Some of the examples of High FODMAP Diet list are:
- Dairy-based milk, yogurt and ice cream
- Wheat-based products such as cereal, bread and crackers
- Beans and lentils
- Vegetables such as artichokes, asparagus, onions and garlic
- Fruits such as apples, cherries, pears and peaches
Low FODMAP Diet NHS
While Low FODMAP Diet list includes:
- Eggs and meat
- Certain cheeses such as brie, Camembert, cheddar and feta
- Almond milk
- Grains like rice, quinoa and oats
- Vegetables like eggplant, potatoes, tomatoes, cucumbers and zucchini
- Fruits such as grapes, oranges, strawberries, blueberries and pineapple
Hope you enjoyed our article on FODMAP Diet- NHS. Need PDF for this file? Have feedback or queries? Let us know in the comments section below. Please note these notes are made exclusively for PLAB 1 exam.