Over the holidays, Rita, my incredible wife, complained about headaches and stomach problems. She tried some different remedies that she had used in the past, but the problems persisted. Then one night at dinnertime, she complained of extreme stomach problems. Initially, Rita assumed it was a stomach ache. But in the next few hours, her pains became extreme. The result: a terrible night spent in the emergency room at our local hospital.

At first, the doctors assumed she had acute gastritis or a gall bladder attack. Tests and further diagnosis by her gastroenterologist indicated something completely different: Rita was suffering from food allergies, particularly lactose intolerance, gluten sensitivity and fructose malabsorption.

Ironically, Rita has been extremely careful about her diet. We previously wrote about how we embarked on a change in our lives two years ago, dramatically changing what we eat and embracing daily exercise, which allowed us to lose over 220 lbs. in little more than a year. That her attack came so suddenly surprised both of us. So Rita immediately went to work.

With the help of Dr. Angie Sadeghi, an outstanding gastroenterologist with the Irvine Odessey Medical Center, Rita started a low FODMAP/IBS diet and eliminated anything with lactose (milk) and gluten (wheat, barley, rye). The results were immediate: her pains stopped and bloating disappeared. Her crashing headaches ceased. She lost several pounds almost overnight. Rita was an entirely new person. Ironically, many of the foods Rita had previously tried to feel better were actually making her worse. So closing doors to some old favorite foods immediately had benefits.

In case you’re wondering, FODMAP is an acronym for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols (that’s a mouthful). These are complex names for a collection of molecules found in food that can be poorly absorbed by some people. FODMAPS are often dietary causes for symptoms of Irritable Bowel Syndrome, or IBS. The reaction that some people like Rita experience from eating foods containing these elements can be sudden and severe. The good news is that when properly diagnosed, the problems can be tamed almost immediately.

What did Rita have to give up? Under her new lactose and gluten-free and FODMAP diet, Rita bid farewell to the following (among many other foods):

Gluten (no wheat, barley, rye)
Milk products (lactose free)
Select fruits and vegetables such as apples, stone fruits, watermelon, artichokes, mushrooms, cauliflower, soy products
Onions and garlic
High fructose corn syrup (a big no-no anyway)
Hummus
Honey
Dried fruit
Artificial sweeteners (isomalt, mannitol, sorbitol (Splenda), xylitol)

So what can Rita eat? Actually, quite a bit. With a few adjustments to her recipes, we could enjoy things we love without missing a beat. Below are some major foods Rita now avoids that are high in FODMAPs, and what she uses instead:

Oligiosaccharides
Avoid: Onions, wheat, leeks, nectarines, barley, rye, lentils, pistachios, kidney beans, chickpeas, broccoli
Eat Instead: Quinoa, corn, potato, buckwheat, eggplant, pumpkin, bok choy, cucumbers, endive, tomato, zucchini, gluten-free products

Lactose (Disaccharide)
Avoid: Milk, cottage cheese, ice cream, yogurt
Eat Instead: Feta, swiss cheese, cheddar cheese, lactose-free dairy products, soy/almond milk alternatives (ensure inulin is not added ingredient)

Fructose (Monosaccharide)
Avoid: High-fructose foods like apples, mangos, honey, asparagus, pears and other stone fruit
Eat Instead: Banana, blueberries, kiwi, strawberries

Polyols
Avoid: Avocado, mushrooms, cauliflower, prunes, peach, cherries, blackberries, sugar alcohols (xylitol, sorbitol)
Eat Instead: Almonds, pine nuts, honey dew, raspberries, stevia

We also discovered that a low-FODMAP diet is considered temporary. Experts in the field suggest slowly introducing one excluded item at a time to see how you react. Doing so will help you understand what foods trigger allergic reactions. On a low-FODMAP diet you aren’t eliminating different types of carbohydrates completely. You’re just reducing them.

Before starting low FODMAP diet, be sure to talk to your doctor. Once you do, commit to the diet for at least four weeks before you determine if it’s beneficial for your digestive system. It’s a good idea to keep notes and a journal along the way to document changes and pain you experience.

There are a number of excellent information resources and foods available for people suffering reactions to lactose, gluten and high FODMAP foods. While it’s a drag for Rita to have to stop eating Greek yogurt or dried figs, she has already found a variety of non-lactose yogurts at the grocery store that fulfill her needs and keep her palette happy.

If you’re getting headaches, sharp stomach pains, bloating and more, take a look at what you’re eating, and talk to your doctor. Not everyone has the reactions that Rita does, but it’s good to know. Below are a few resources that we hope might get you started.

Articles
Stanford University Hospital: Low FODMAP Diet information sheet (pdf)

Kate Scarlata: FODMAPs Information

Kate Scarlata: FODMAPs Checklist

Kate Scarlata: Low FODMAP grocery list

Kate Scarlata: What you should know about FODMAPS (pdf)

Kate Scarlata: Gluten free does NOT mean low FODMAP!

Grace Gold: Is FODMAP the new gluten-free diet? IBS specialists say yes

Amy Burkhart MD: Fructose Malabsorption

The Watson Center: Tips for success on the low FODMAPs diet

NPR: Sensitive to gluten? A carb in wheat might be the real culprit

Chris Kresser: FODMAPS – Could common foods be harming your digestive health?

Websites
Patsy Catsos: IBS – Free at Last! FODMAP diet section (highly recommended)