By Dr Harold Gunatillake - Health Writer

Many people more often take for granted, or may assume will normalise with time, and also may get embarrassed to discuss the subject with their family or their doctors and suffer in silence from gastrointestinal symptoms.

The known GI conditions such as coeliac disease and Irritable Bowel Syndrome (IBS) are diagnosable today and doctors seem to know more about these ailments as they are becoming more and more prevalent.

However, people who have these symptoms need not to tolerate them since such abdominal symptoms are certainly abnormal. The importance of having symptoms checked and figuring out the triggers can lead to resolving the discomfort in a simple and effective method. As reiterated by leading dietician and founder of the Low FODMAP Diet, Dr Sue Shepherd, "It is essential that people with abdominal symptoms are investigated for coeliac disease by their doctors".

The symptoms in both coeliac disease and IBS are similar; vague abdominal pains with bloating and discomfort being constipated or having lose bulky stools. Coeliac disease is a serious debilitating condition, and you must get checked up by your doctor as early as possible. It may lead to softening of your bones (osteoporosis) due to depletion of calcium, or may cause infertility, cancer and autoimmune conditions like diabetes. On the other hand one could live a lifetime with IBS if the person is aware of the problem for symptoms may temporarily subside by taking in over-the-counter medicine. IBS is very common, one in seven will get affected with IBS, and coeliac disease being rarer, one in about 70 will be affected.

In tropical countries, IBS is much more common because people in these countries consume spicy curries and processed foods like white rice and white bread and other foods cooked with white flour. Most of these people's stools are loose and not well formed by eating low fibre and unprocessed foods.

Coeliac disease
The immune system of the people who suffer from coeliac disease reacts abnormally to gluten – a protein found in wheat, rye, barley and oats, causing damage to their inner lining of the gut. The tiny finger like projections on the inner lining of the gut which help absorb digested food become inflamed and flattened with time. Wasting of these projections (villi) causes gastrointestinal and malabsorption symptoms.

This disease affects people of all ages, both males and females. People with coeliac disease remain sensitive to gluten throughout life. They need to consume a strict gluten free diet to remain free of symptoms.

Low FODMAP diet for irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) affecting one in seven Australian adults. FGID is also common in the USA, Europe and many Asian countries. This condition is characterized by chronic and relapsing symptoms; lower abdominal pain and discomfort, bloating, wind, distension and altered bowel habit (ranging from diarrhea to constipation) but with no abnormal pathology. The diagnosis of IBS/FGID should be made by a medical practitioner.

Can we prevent IBS completely? Unfortunately the answer is no, but Dr Barrett suggests that having a healthy gut flora may help. This means eating a nourishing, high fibre diet with lots of fruit, vegetables, grains and legumes. Eliminating high-processed foods, fast foods and high sugar foods, including sweet drinks and sodas, can improve our gut health; and sticking to 'whole foods' rich in essential nutrients is the best thing for a healthy and happy body.

High processed foods like white rice, white bread, and other foods cooked in processed wheat and rice flour needs to be avoided, to have a comfortable stomach at all time… Sweet drinks, Sodas, and sugary and fast foods should be avoided in your routine diet.

FODMAP stands for:
Fermentable – meaning molecules are broken down (fermented) by bacteria in the large bowel.
Oligosaccharides – 'oligo' means few and 'saccharide' means sugar. These molecules are made up of individual sugars joined together in a chain.
Disaccharides – 'di' means two. This is a double sugar molecule.
Monosaccharides – 'mono' means single. This is a single sugar molecule.
Polyols – these are sugar alcohols (however, don't lead to intoxication!).

Foods that are included in FODMAP classification include many food items. There are friendly FODMAP diets and unfriendly FODMAP diets. The unfriendly high FODMAP diets give rise to abdominal symptoms mentioned before.

High FODMAP food (things to avoid/reduce) if you suffer from IBS
Vegetables and Legumes
Garlic – avoid entirely if possible
Onions – avoid entirely if possible; Asparagus: Baked beans: Beetroot: Black eyed peas: Broadbeans
Butter beans: Cauliflower: Celery – greater than 5cm of stalk: Kidney beans: Leeks: Mange Tout:Mushrooms
Peas: Savoy Cabbage: Soy beans: Split peas: Scallions/spring onions (bulb/white part): Shallots
Fruits can contain high fructose to avoid/reduce
Apples: Apricots: Avocado: Blackberries: Cherries: Currants: Dates: Grapefruit: Lychee:Mango: Nectarines
Peaches: Pears: Persimmon: Plums: Pomegranate: Prunes: Raisins: Tinned fruit in apple/pear juice: Watermelon
Low FODMAP food (good to eat food) if you suffer from IBS

Vegetables and Legumes
Alfalfa: Bean sprouts:Bok choy/pak choi: Broccoli – avoid large servings: Brussel sprouts – 1 serving of 2 sprouts: Butternut squash – 1/4 cup: Cabbage – 1 serving of 1 cup: Carrots
Celery – less than 5cm of stalk: Corn / sweet corn- if tolerable and only in small amounts – 1/2 cob: Chick peas – 1/4 cup: Chilli – if tolerable: Chives: Cucumber: Eggplant/aubergine: Fennel: Green beans:Green pepper (green bell pepper): Ginger: Kale: Leek leaves: Lentils – in small amounts: Lettuce: Okra: Olives: Parsnip: Parsley: Radish: Red peppers (red bell pepper):Potato: Pumpkin: Scallions/spring onions (green part): Spinach, baby: Squash: Sweet potato – 1/2 cup: Tomato – avoid cherry tomato: Turnip: Zucchini

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