Dr. Zorba Paster: Low FODMAP diet may help
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Dr. Zorba Paster: Low FODMAP diet may help

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Dear Doc: I don’t think I have seen you address this issue. I am prone to sudden and emergency requirements to find a bathroom with just two to five minutes notice, primarily before noon.

In my previous job, I usually needed one to three emergency stops per morning commute. I am fine in the evening. Stool is normal, not loose or constipated. I eat a bland diet and take whole psyllium fiber daily.

Anti-cramping medicine, antacid, Imodium, Pepto Bismol — none of it helps. I cannot work full-time since I need “recovery breaks” from the exhaustion of this crazy, random thing. I had to pass up a great job offer because that morning commute would offer no easily accessible bathrooms.

I’m possibly going to go broke, as I am too young for Social Security and “too healthy” for disability. Any solutions for these sudden spasms? Thanks. — J.P., from Rochester, New York

Dear J.P.: You are in a pickle. I assume you’ve seen a doctor about this. If you haven’t, you should because lots of things can cause this discomfort — from serious illnesses such as ulcerative colitis to Crohn’s disease to giardia and other parasites that might lurk in your gut from international travel.

But I’m going to assume you’ve had a complete workup by your doctor and friendly gastroenterologist and that everything is negative. That means you have the catch-all problem of IBS — irritable bowel syndrome — which is described as a “widespread condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety or previous intestinal infection.”

Got it? It’s a gut problem about which we really have no idea.

Now, what’s nice here, in one way, is to give you a diagnosis, a title. Patients hate it when I say I don’t really know what’s going on — which is, by the way, the case with most IBS. But when we give it a label, there is a sense of relief. Ah, I have IBS. It’s not all in my head, although you see by the IBS definition that for some it is in their head.

So what’s the cure? Is there a cure? Is there a treatment? Is there something natural you can do that just might work? I refer you to the FODMAP diet.

FODMAP is an acronym that stands for Fermentable Oligo-, Di- and Monosaccharides and Polyols. These are types of carbohydrates that many people find hard to digest in the gut. They naturally occur in food and are often added to prepared food for taste and texture.

Those who are sensitive to FODMAPs often have small intestinal distention from the inability to fully digest them. Trying a low-FODMAP diet may help with the symptoms and awful discomfort you have been experiencing.

The diet is a bit tricky — not as simple as just eating your fruits and vegetables. That’s because some fruits and veggies contain more FODMAPs than others, and all foods no matter how healthy they seem will vary on the FODMAP scale. Try a Google search for “FODMAP diet” to learn what foods to eat and what to avoid. Stay well.

This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.

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