When diagnosed with fructose malabsorption and or irritable bowel disease, the first goal of management is to restrict as many foods as possible to make you symptom free. As a general statement, during this initial phase it is best to reduce the fructose, major sources of wheat, fructans, oligossacharides, resistant starch plus other items.
Practically this means, Helen needs to show you which fruit, vegetables to eat and how much wheat to reduce in your diet. Finally there are particular ingredients you need to avoid when reading the ingredient list from processed foods.
Step (1) Reduce as many offending foods a possible simultaneously for a 6 week period (can take longer in some cases). The recipes provided within the website are related to step one.
Step (2) Once symptom free, re-introduce foods via a challenged process to determine your individual tolerance
So where to from here, all of the information in step 1 and 2 can be covered via one online presentation, or you can book into see Helen over two appointments at one of her clinics or a skype meeting.
So what is the difference between Irritable bowel syndrome (IBS) and Fructose Malabsorption? Not much. Fructose malabsorption forms an element of IBS. SO to manage IBS it ofgten also requires a low FODMAP diet.
Irritable bowel syndrome (IBS) is a complex disorder with a wide range of symptoms, some of which may be related to diet. Poor eating habits such as skipping meals, low intake of fibre and fluid, excessive fatty food intake, sensitivity to milk and other dairy products (see lactose intolerance) and excessive caffeine and alcohol need to be addressed as a first step in helping relieve symptoms in IBS.
General dietary advice in patients with IBS
The most common dietary treatment for IBS has been, and still is, a high fibre diet. While this is still a positive recommendation for many patients, especially those who suffer from constipation, some patients will not benefit from an increase in dietary fibre, and in some the symptoms may even worsen. As with any change in diet the increase in fibre should be gradual, involve a variety of fibres and an adequate fluid intake of at least 1.5 litres per day. The major sources of fluid should be water.
IBS symptoms tend to be increased following large meals, particularly if the meal is high in fat, and if the meal is eaten quickly. It can be helpful to spread the food over 3 meals and 3 snacks per day. Avoid eating quickly and try to relax after a meal. Regular light exercise can also help reduce symptoms.
If excessive wind is a problem then exclusion of the ‘windy vegetables’ including broccoli, cauliflower, cabbage and legumes including baked beans may be helpful. These may be reintroduced once the symptoms have settled. Carbonated soft drinks can also exacerbate symptoms. Like food, fluid should be spread across the day.
Some individuals with IBS may find a trial of lactose exclusion helpful. Lactose is found principally in dairy products such as milk and ice creams (see lactose free diet). Remember that these foods supply important nutrients, and reduced consumption can affect calcium intakes.
Sensible eating for IBS sufferers
Keep a food, fluid and symptoms diary to help observe the role of diet and other factors such as stress in symptoms. Start with the basics of 3 low fat, high fibre meals and 2 -3 snacks per day. Maintain an adequate fluid intake, avoiding excessive intake of fizzy drinks and caffeine. Eat slowly and make meal times as relaxing as possible.