While low-FODMAP diets have been shown to help ease the symptoms of irritable bowel syndrome (IBS), until now researchers weren’t sure whether these eating plans could alleviate the symptoms of IBD. But a study published in October 2019 in the journal Gastroenterology found that when people with IBD, including UC, stuck to a low-FODMAP diet, they experienced a significant reduction in several gut symptoms after just four weeks. While adopting the diet had no effect on disease severity, the research adds to the growing evidence that a low-FODMAP diet may help ease GI symptoms and improve a person’s overall quality of life. Thinking of giving a low-FODMAP diet a try? Here’s what you should know before you get started. “So far, there has been no evidence that any diet can cause or prevent inflammation of the bowel,” says Bo Shen, MD, a gastroenterologist and the medical director of the Inflammatory Bowel Disease Center at NewYork-Presbyterian/Columbia University Medical Center. “But a low-FODMAP diet, which is essentially a low-carb and low-fiber diet, has been the most scientifically studied diet to date.” What’s more, he says, low-FODMAP diets can help control some of the symptoms of Crohn’s or UC, which together affect around 3 million people in the United States, according to the Centers for Disease Control and Prevention. The exact causes of IBD are unknown, according to the Crohn’s and Colitis Foundation, but genetics have been shown to play a role. Researchers are also starting to study the microbiome, the unique composition of bacteria in the human gut, in the hopes of learning how it’s related to chronic inflammatory diseases. What we eat can have a large impact on those bacteria, says Dr. Shen. For example, fiber and simple carbohydrates such as sugar — in other words, FODMAPs — are the primary food sources of bacteria, so eating a diet heavy in those nutrients can often exacerbate gastrointestinal symptoms, such as bloating, gas, and lower abdominal pain, particularly in people with IBD. “Excess fiber in the diet can make those symptoms worse,” he says.
How a FODMAP Diet May Help Ease IBD Symptoms
In the 2019 research, scientists tracked 52 people with IBD by measuring their persistent gut symptoms, markers of inflammation, and fecal microbiome. At the end of the 4-week study, 52 percent of people who followed the low-FODMAP diet reported relief of gut symptoms after the trial, compared with just 16 percent of people who followed a control diet. Plus, those who stuck to the low-FODMAP diet scored higher on quality-of-life assessments. While the researchers concluded that a low-FODMAP diet is safe and can help control symptoms of Crohn’s and UC, one of the difficulties of studying the microbiome is that everyone’s gut bacteria is distinct, says Shen. “Each of us has at least 5,000 different kinds of bacteria in our gut,” he says. That makes drawing valid conclusions from comparisons among people difficult. Further research could focus on comparing the microbiome of the same patient before and after a low-FODMAP diet.
What to Eat — and Avoid — on a Low-FODMAP Diet
Until more research emerges, current evidence suggests that following a low-FODMAP diet and limiting high-fiber, high-carb foods can help people with IBD feel better. On a typical low-FODMAP diet, foods to avoid include:
ApplesAsparagusBeansCauliflowerCow’s milkGarlicHoneyPastaSoy milkWheatYogurt
But there is also a lengthy list of foods that are acceptable on the diet, such as:
Almond milkBananasCitrus fruitsCarrotsCucumbersEggplantEggsGrapesGreen beansHard cheesesLean meatsPeppersPotatoesTomatoes
“This diet is not very restrictive, since there is a wide spectrum of foods to choose from, and is fairly easy to follow,” says Shen, who likes to tell people, “It’s not no FODMAP, just low FODMAP.” Certain foods, such as apples, can be made diet friendly by peeling them, since most of the fiber is in the fruit’s skin. There’s also very little risk in trying the diet. You are still able to get all the nutrients your body needs, including fiber. “Even a low-FODMAP still has some fiber,” Shen says. Overall, following this diet can be another option to help you manage your UC symptoms and take back some control over your health and life.
