I have a notoriously delicate constitution. My innards tend to react like an angry toddler needing its bedtime over all kinds of things. Some of it is because I am an expert maker of gallstones (despite having my gallbladder removed when I was 18) leading to my digestive system reacting like angrily to say the least. I’ve done a lot of exclusion diets in my time.
There was the post cholecystectomy low fat diet that meant all I could safely eat without a trip to A&E was bread and jam which in turn meant having to do a candida exclusion diet. Not only am I prone to yeast issues in my gut but because it was the mid 90s and it was the current solve all your internal ills idea at the time. I also dabbled with wheat and dairy free for a while and didn’t achieve much effect apart from sending myself gently bonkers around food. I’m sure I’d have excluded gluten too if I’d heard of it then.
I thought I’d just have to put up with feeling terrible all the time and existing on a heavy routine of peppermint oil capsules and mint tea and then I saw a new and wonderful gastroenterologist about some other gallbladder related issues you don’t want to read about over breakfast. While not denying I had a problem, he mentioned that about 80% of his current caseload is down to three things: poor gut flora, Chorleywood bread and Fodmaps.
The first, I know well. The second makes sense since it relies on underproving yeasts and gluten and making bread much harder to digest. The third? I had no earthly idea what he was on about. But I trusted him (I should, he swears like a sailor on shore leave, keeps a sourdough starter in his office for patients and is Michael Mosley approved, all on the NHS no less) so I went off and looked these Fodmaps up.
Discovered by Monash University in Australia, it identifies that there are certain sugars and carbohydrates that the human body finds hard to digest leading to problems. These are the Fermentable, Oligo, Di and Mono Saccharides and Polyols the diet is named for. Often confusing for people because many healthy foods are an issue, it’s a complicated diet that should only ever be undertaken with the help of a trained medical professional, hopefully via the NHS these days,
However it’s worth looking into doing it if you find you have issues after eating wheat or rye, all dairy products not just lactose based ones, certain fruits and vegetables, especially onions and garlic or pulses beyond the normal response to large amounts. Meat substitutes like Quorn can only be a big Fodmap trigger. People are further confused by Fodmaps because everyone’s tolerance is different. I am absolutely fine with wheat (and other members of the galactan family) and have no issue with lactose.
Yet give me a fructan in the shape of an onion or garlic especially and I am utterly miserable. My problems are compounded by the fact I am also fructose intolerant so react terribly to high fructose fruit, any kind of fruit juice and anything like agave syrup that’s high in it. It’s best to only consume fructose when it comes with the natural fibre of the fruit to prevent overloading your system but for fructose malabsorbers like me, any amount is difficult. A glass of orange juice or a whole apple will be both cause my mouth to swell and break me out in a sweat and itchiness. I suspect many people have this issue these days but have simply never heard of it. Innocent times. Literally.
I have to be incredibly careful in what I eat so that I don’t end up lying down feeling faint and bloated at best or triggering off my more intense bowel issues. Fruit and pulses are occasional treats for me (which is why I become murderously annoyed when people tell me how great lentils are when you are poor) and alliums are to be eaten only when I can’t avoid them and can be alone soon after. I will never eat a Jerusalem artichoke or chicory root or take a prebiotic again as they contain inulin, a form of indigestable fibre that is problematic for everyone but triggers debilitating biliary pain for me. Read more →