Does a Low-FODMAP Diet Help Reduce Intestinal Inflammation and Autoimmunity?

Often times, we hear about the low-FODMAP diet in relation to SIBO—small intestinal bacteria overgrowth. However, today we’re going to talk about the potential benefits of a low-FODMAP diet for other digestive conditions, specifically those conditions resulting in inflammation and autoimmunity in the small intestine.

If you need help getting started with a low-FODMAP diet, click here

Does a Low-FODMAP Diet Help Reduce Intestinal Inflammation and Autoimmunity? - AdobeStock 202770924 WEB FODMAP food diet L

Does a Low-FODMAP Diet Help Reduce Intestinal Inflammation and Autoimmunity?

In Monday’s video, we discussed a study that demonstrated patients with Crohn’s disease in the small intestine who did much better on a low-FODMAP diet vs. a high-FODMAP diet.

The study involved nine patients with clinically quiescent Crohn’s disease, and they were randomized to 21 days on a low-FODMAP diet or a typical Australian diet. Five-day fecal samples were collected at the end of each diet and analyzed for calprotectin, pH, short-chain fatty acids (SCFA), and bacterial abundance. Gastrointestinal symptoms were recorded daily.

The diets had no effects on calprotectin, but symptoms doubled in severity with the Australian diet. SCFA, pH, and total bacterial abundance remained unaltered, but relative abundance was higher for butyrate-producing Clostridium cluster and mucus-associated Akkermansia muciniphila, and lower for Ruminococcus torques during the Australian diet compared with low-FODMAP diet.

One potentially negative effect of reducing FODMAP intake is the change it induces in the gut microbiota in patients with IBS and healthy controls. One study showed a reduction of the relative abundance of Bifidobacteria in the feces. In a more detailed analysis, a low-FODMAP compared with moderate FODMAP intake was associated with one-third reduction in the total abundance of fecal bacteria.

What is a FODMAP?

FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” They are a collection of short-chain carbohydrates and sugar alcohols found in foods naturally or as food additives. They include fructose (when it’s in excess of glucose), fructans, galacto-oligosaccharides (GOS), lactose, and polyols.

FODMAPs are food for your bacteria. So, in a healthy person, a moderate- to high-FODMAP diet is a great option because you’re feeding your gut a lot of prebiotic fiber to support your microbiome. However, if there’s dysbiosis or inflammation in the small intestine, these FODMAP foods might exacerbate symptoms.

A low-FODMAP diet has been shown in research to be helpful symptom management for IBS and SIBO. According to the study above, a low-FODMAP protocol might be helpful for other conditions of the small intestine as well.

Is a low-FODMAP diet safe long-term?

While staying on a low-FODMAP protocol long-term is not ideal, it may be necessary for some people. The potential harm is that you’re starving your gut flora and could potentially reduce the diversity of bacteria and the overall amount of bacteria in your gut.

There are some prebiotic fibers that have been shown to be better tolerated than others in patients with IBS. Acacia fiber is a low-FODMAP prebiotic supplement. It’s easy to mix in water or a smoothie. Also, a prebiotic called Bimuno has been shown to be well-tolerated in SIBO patients, even though it is a GOS (FODMAP). The probiotic/prebiotic supplement, Prescript Assist, has demonstrated beneficial effects in IBS patients as well.

If you’re struggling with chronic digestive issues, then it may be helpful to try a low-FODMAP diet for a few months. As your symptoms improve, try adding some FODMAP foods back into your diet one at a time. You’ll likely find that you can tolerate some while you can’t tolerate others. Additionally, you’ll probably find that it’s very dose dependent. You may be able to eat five brussels sprouts with no issues but 10 is too many for you. Or you may find that you can eat apples but not garlic. The key is to find your own customized protocol that offers the most variety in food choices while minimizing your symptoms.

If you need help getting started with a low-FODMAP diet, click here

What do you think? I would like to hear your thoughts or experience with this.


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