Low-FODMAP Diet for Intestinal Inflammation and Autoimmunity

Can a low-FODMAP diet help with small intestinal inflammation and autoimmunity? Let’s discuss a recent study where two groups were fed either a high- or a low-FODMAP diet, expand on what happened to gut bacteria, and more importantly the effect on symptoms.

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Low-FODMAP Diet for Intestinal Inflammation and Autoimmunity

Dr. Michael Ruscio: Can a low-FODMAP diet help with intestinal inflammation and intestinal autoimmunity?

Hi, this is Dr. Ruscio. And let’s talk about a very interesting study that was recently published that looked at what happens in those with intestinal inflammation and intestinal autoimmunity as seen in Crohn’s disease—Crohn’s disease being where people have inflammation and autoimmunity in their small intestine. What happens if we take people with this condition who are somewhat stable and we then put them on either a low-FODMAP diet or a high-FODMAP diet?

And if you’re unaware or unfamiliar with FODMAPs, FODMAPs are essentially types of carbohydrates—high-FODMAP foods, that is. High-FODMAP foods are types of carbohydrates that can feed bacteria and are very fermentable. So they feed the bacteria in your gut. And this can be a good or a bad thing depending on the person.

For many people with gastrointestinal symptoms, issues, problems, things like IBS or small intestinal bacterial overgrowth or Crohn’s disease or ulcerative colitis, these symptoms that typically manifest as gas, bloating, constipation, abdominal pain, loose stools, frequent stools, or even in some cases constipation. This type of approach of eating low FODMAPs can actually be very helpful because it seems that an approach of limiting how much we feed bacteria seems to help.

And that was reinforced by this study.

There was a near doubling of the symptoms in the patients that ate the high FODMAP compared to those that ate the low FODMAP.

Now, what’s interesting here is that the group that ate to feed bacteria, that ate the higher FODMAP diet and had the symptomatic flare. They also saw an increase of bacteria that we think are healthy. Akkermansia muciniphila—I believe is the pronunciation—is an anti-inflammatory bacteria that seems to be healthy, or at least we think. Yet when these patients ate in a way that increased that bacteria, they got sick.

And so I think what’s important to keep in mind, especially if you’re a doctor or if you’re a health care consumer and you’re reading about all this cool stuff we’re learning about all the bacteria in our gut, is that we want to look at these things in a large context, not in the context of, “This bacteria is good. If we can increase this one bacteria, then that should make the patient healthy” because what we see here is we increased that healthy bacteria. But the patients got sick. So looking at this from a bigger picture in terms of how does whatever the intervention is affect someone’s health and well-being?

So in this study, we show that those that have Crohn’s disease—which Crohn’s disease affects about—in 80% of the cases, it affects the small intestine. Those with Crohn’s disease, when they went on a low-FODMAP diet, they looked pretty good symptomatically.

When another group went on a high-FODMAP diet, yes, they saw a healthy bacteria increase because of the bacterial feeding nature of high FODMAPs. But they symptomatically were much worse. In fact, their symptoms were about doubled.

So a low-FODMAP diet has a lot of applications for helping with different types of gastrointestinal conditions including inflammatory bowel disease likely because it starves bacteria. And even though bacteria can be good for us, in a lot of cases, it seems that—and especially for those that have gastrointestinal problems—an approach that limits, or doesn’t feed bacteria, seems to be a favorable strategy.

So this is Dr. Ruscio. I hope this information helps you get healthy and get back to your life. Thanks!

If you need help with inflammation, digestion, or autoimmunity, click here

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