Many of my IBS and SIBO patients come in after months or years on the low FODMAP diet. Don't worry- It is 100% possible to safely add these foods back into your diet if you play your cards just right! I've coached many folks through this process before.
More often than not, the low FODMAP diet is prescribed for IBS without any discussion on how to resume normal life afterward. So what do you do when you find yourself stuck on this grueling diet?
First, some vocab-
IBS = Irritable Bowel Syndrome. Symptoms include bloating, stomach pain, and altered bowel movements (either diarrhea, constipation, or a yo-yo between the two). There are many causes of IBS (Youtube video series here).
SIBO = Small Intestinal Bacterial Overgrowth. This is the most common cause of IBS, and tends to have similar symptoms.
Low FODMAP diet = A diet that eliminates or drastically reduces the following types of fiber: Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides, and Polyols. This includes many types of fiber from fruits and veggies, fiber supplements, and artificial sweeteners like xylitol.
Long-term use = more than 2 weeks (in my opinion for this diet)
Problems with the long-term use of the low FODMAP diet:
It's HARD and it doesn't let you have much of a life. How much does it totally stink to not be able to go to restaurants, eat with family, or go on a vacation without a 100 lb cooler? Don't fool yourself- that constant stress chips away at your health and sanity (with good reason!) the longer you do this diet.
Inflammation. You can read more about this in my e-book, but the jist of it is that fiber is good for you and without it the bacteria in your colon will suffer. If your colon bacteria (microbiota) are unhealthy and unhappy, so are you.
Susceptibility to disease. I strongly believe that long-term use of the low FODMAP diet makes you more vulnerable to things like autoimmune diseases, food-borne illness (like food poisoning), digestive disorders and infections (ex. C-Diff infection), and quite possibly cancer.
It does little to nothing to treat the problem. Starving SIBO doesn't actually kill it, it just keeps your symptoms more manageable (see the video below). Wouldn't you rather get to the root of the problem and actually treat your SIBO? I sure as heck would!
What to do?
Being stuck on the low FODMAP diet is a catch-22 of awfulness. Eat this way and never feel normal again, or go off the diet and bloat so much you look 8.5 months pregnant. If your gut can't tolerate these foods, you're just doomed, right? Wrong.
If you break your leg and need a crutch, it's not practical for me to say "just don't use the crutch." You need that crutch until you heal your leg! Similarly, low FODMAP can be seen as a crutch for IBS and SIBO in the first few weeks of treatment. If you need it for a while, that's OK. If you become dependent on this diet, then you likely need some professional help. I can't say that it's easy or cheap to heal your body and walk without this crutch, but it can be done. Below are a few important things to address to heal your gut and get off the low FODMAP diet- they are in approximate order of importance.
Things to address with your healthcare team:
(Properly/thoroughly) treating SIBO and/or dysbiosis (consider a good stool test)
Digestion- stomach acid, enzymes, bile, etc
Immune system health/strength
Also, other infections that can stress the immune system (like EBV)
Thyroid function (testing more than just TSH and T4!)
Motility/MMC/Vagus nerve function
Inflammation and autoimmunity
Lastly, you'll want a good plan before diving in- don't approach this process willy-nilly. Before you reintroduce a food you should check off all of the above, and make a list of what you're going to reintroduce and when.
Wishing you the fluffiest of poops,