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Wed, Jan 9 2:51pm · Fructose Malabsorption in Digestive Health

Totally agree with guthealth regarding the FODMAP diet. I'm still on the reintroduction phase of the diet and not quite yet at the total low-FODMAP diet stage. I have also found it is very important to follow a certain method for the diet to work….and to really strictly follow it. I have yet to cook any low-FODMAP recipes. I just make things that are in my current allowed list based on the program the nutritionist helped me define. I cannot have salsa, garlic, onion, beans, etc. yet. Not at this stage.

As you progress slowly adding foods, you may find that the quantity and frequency may also be a determining factor. For example, you might be able to tolerate 1/4 cup of beans but not 1/2 cup. Or you can have chocolate one day but cannot have it again for another 3 days. I know I can have 1 Hershey's chocolate kiss to satisfy my craving; but no more!
But I'm also one of the lucky ones that just has FM; no other major complicating factors.

One thing I have learned….and I think its because my system is so 'clean' now due to the elimination phase of the diet (which I extended well beyond the 8 weeks). In the past I could eat something and really not feel well and have issues, but now my intolerance reaction is a lot more intense. I accidentally had mayonnaise at a restaurant (big no/no; they use HFCS). I was in severe pain from the cramping. In bed for 2 days back/forth to bathroom. I'll never make that mistake again!

Mon, Jan 7 10:38am · Fructose Malabsorption in Digestive Health

During FODMAP elimination phase, I could eat variety. Fruits like bananas, blueberries, cantaloupe, lemon, raspberry, strawberry, tangerines; veggies like green beans, carrots, eggplant, kale, lettuce, potatoes, spinach, tomatoes, zucchini; meats like chicken, turkey, beef, fish,pork, shellfish. I could have eggs, peanut butter, butter, margarine, olive oil, beer, wine, coffee, tea. Seasonings like salt, pepper, parsley, oregano, dill, rosemary, etc.

I know I can handle lactose so I had milk, cheese, etc. Was totally gluten free.

The biggest issue is sweeteners in prepared foods and sauces, salad dressing, etc. Absolutely NO garlic or onion. So I use olive oil and lemon on alot of things to provide flavor. Yes, it is fairly bland and limited in scope.

Hard to eat out or at someone else's home. My friends understand and are very patient with me when I order at restaurants!
I have to be very specific with the waiter about how to prepare the food and what not to include, etc.

Obviously everyone is different and may have other health conditions/GI issues that make this more difficult.

A good resource for Low FODMAP foods is http://www.katescarlata.com/
Also https://www.monashfodmap.com/. Monash Univ in Australia created low FODMAP diet for IBS

Hope this helps!

Mon, Jan 7 10:23am · Fructose Malabsorption in Digestive Health

I see the Mayo nutritionist in person.
After my tests, my Mayo GI initially gave me the Mayo Clinic Fructose Malabsorption Eating Plan and recommended seeing the nutritionist, which I did. She then gave me the FODMAP Eating Plan (20 page booklet). I don't know if it is available online or how you get it if not a patient.

There are no firm rules about which foods you start with or the order but the Plan highly recommends you follow their rules/ recommendations if you want to figure out which foods caused your symptoms. You reintroduce 1 FODMAP group at a time and 1 food at time. My nutritionist gave me the order of FODMAP groups to work. The groups (in the order I'm working) are Galactans, Polyols, Fructans, then Fructose (I don't have an issue with Lactose; if so, they would be a group as well).

Within each group there are a a list of foods. You start at the bottom of the list and work up (from lowest FODMAP to highest). What she has me doing is 1 new food every 3 days. Eat the (last) food on the list for day 1, 2 and 3. If on day 1, I don't feel well then wait until I feel better (maybe 3 days) and then try the next food on the list. I then know that I cannot tolerate (or eat) that food. I can always try again in smaller amounts.

If I can tolerate that food, then I wait a day and start with the next food in the same group. As I work myself 'up' the list for the food group, if I find 2-3 in a row that don't work for me, then I probably won't be able to tolerate anything else higher in that food group list.

Once complete a group, go back to basic diet before starting next group and stop eating foods from the first group. Wait about 3 days before starting the new group. Etc.

It is very tedious, but the whole goal is to figure out what you can eat.

There is a website she recommended: http://blog.katescarlata.com/tag/fody-foods/
It contains a Low FODMAP grocery list.

Plus http://www.fooducate.com to get label information of lots of different types of groceries.
And http://www.fodyfoods.com for low fodmap foods you can purchase. They have a really good snack bar (since my old favorite protein bars weren't making my stomach happy!)

Also, for gaining weight there is Nestle ProNourish digestive wellness drink (gluten free, suitable for lactose intolerance, low FODMAP).

Mon, Jan 7 10:01am · Fructose Malabsorption in Digestive Health

Hi. The test is actually a "hydrogen breath test" (google it for more info). As far as I know there are 3 individual types of hydrogen breath tests: fructose malabsorption/sugars, lactose intolerance, small intestine bacterial overgrowth (SIBO).

Each test (mine done on separate days) takes a few hours. They take a breath measurement, have you drink some stuff, and then take measurements at intervals (ie, every 20 minutes). Basically if your body cannot digest the substance, it will ferment in the colon and produce hydrogen and other gases. That is what they are measuring. Larger than normal amounts of exhaled hydrogen measured during a breath test indicate that you aren't fully digesting and absorbing the substance.

Thu, Jan 3 3:05pm · Fructose Malabsorption in Digestive Health

Thanks to everyone. Alot of good info.
Regarding seasonings, have you tried any of the seed spices such as coriander, mustard, cumin, caraway, dill see, sesame seed, poppy seed, etc. to see if you can tolerate those?

I was diagnosed with FM with breathing test. I would highly recommend taking hydrogren breathing tests to anyone who doesn't have a definite diagnosis yet. (FM, Lactose, SIBO).
Regarding diet, I didn't just try low FODMAP. I did NO FODMAP. Total FODMAP elimination except for lactose since I know I don't have an issue with it. All I can say is my diet is very bland (but I'm not a foodie anyway). But never felt better. Slowly adding new foods per the Mayo Clinic FODMAP Eating Plan. It is very specific in the order in which you add categories and individual foods to see if you can tolerant them. I'm doing all of this with a nutritionist at Mayo. I know this is 'no fun', but for me having minimal food options is worth it.

I've also learned to get very good at reading labels. OTC meds are especially a problem. You wouldn't think cough medicine could cause an issue but it can.
Also, GI doc took me off Prilosec and said don't go back on. My stomach felt like it was on fire for at least 2 weeks but apparently it was part of the problem. Also absolutely no ibuprofen products or aspirin for me.
Don't know if any of this helps.

Dec 9, 2018 · Fructose Malabsorption in Digestive Health

Have you heard of and/or tried low FODMAP? I was diagnosed with GERD 20+ years ago but recently they found I am fructose intolerant. They put me on the FODMAP elimination diet/eating plan. Haven't felt better in years. Still in the food reintroduction phase. Lots of good information out there. Starting to think I never really had GERD.