Low FODMAPs Diet Supplement Suggestions

Those embarking on a low FODMAP diet generally have long term digestive symptoms. Healing digestive function can be broken down into 4 stages: Remove, Replace, Reinoculate and Repair. Here’s an explanation of each phase with some potentially useful supplements. Please note, not all of the recommended supplements will be needed by all people and the length of time each person needs to take each supplement will vary. Consult a practitioner for help where necessary and with your GP before embarking on any dietary or supplement programme.

Remove – this phase involves removing problem foods (see FODMAPs fact sheet) as well as herbs and supplements to help remove problematic organisms in the gut such as parasites and yeasts. These may include:

• Aloe vera juice – contains polysaccharides that have anti-bacterial and anti-fungal properties.
• Ginger and garlic – have anti-bacterial, anti-fungal and anti-parasitic properties.
• Cinnamon and oregano – have potent anti-fungal properties.
• Coconut oil – contains anti-fungal compounds such as caprylic acid which can be taken as a supplement.
• Olive leaf extract – has anti-bacterial, anti-fungal, anti-parasitic and anti-oxidant properties.
• Grapefruit seed extract – has anti-bacterial and anti-fungal properties.

Replace – in this phase supplements and herbs to replace and stimulate the production of digestive enzymes and stomach acid may be used:

• Digestive enzymes – whilst a healthy gut produces sufficient amounts of digestive enzymes to break down food many people are compromised in this respect. Digestive enzymes can be taken as supplements with meals to help break down proteins, fats and carbohydrates.
• Papain and bromelain – from papaya and pineapple respectively, both act as digestive enzymes to help break down protein and both may reduce inflammation.
• Betaine and pepsin – both support protein digestion in the stomach. These should be introduced gradually to see if irritation occurs. They are not recommended for those with stomach, duodenal or oesophogeal ulcers.
• Aloe vera juice – may help to regulate the production of digestive juices and ease digestion.
• Phosphatidyl choline, lecithin and milk thistle – may all aid liver and gall bladder function which, in turn, will support gut function and elimination.
• Vitamins, mineral, antioxidants and essential fats – may all be recommended to restore nutritional deficiencies and support the immune system particularly where poor digestion has led to malabsorption.

Reinoculate – during this phase probiotics are given to help restore the balance of good bacteria in the gut. There are many strains of probiotics available. For those needing to follow a low FODMAP diet it is best to look for probiotics that do not contain prebiotics such as FOS and inulin which may exacerbate symptoms:

• Lactobacilli and bifidobacteria – these are the most widely researched species and have been shown to support beneficial bacterial balance and increase short chain fatty acids which aid gut immunity.
• Lactobacillus rhamnosus, plantarum, salivarius – these are hardy strains of bacteria that may be useful for those who don’t derive benefits from lactobacillus acidophilus.
• Saccharomyces boulardii – supports the production of secretory IgA (the main gut immunoglobulin) and helps good bacteria to colonise the gut.

Repair – during this phase the intestinal lining of the gut is repaired so that only properly digested particles enter the blood stream.

• L-glutamine – supports cell growth in the walls of the intestines thus creating a good gut barrier.
• Phosphatidyl choline – supports healing of the gut mucosa.
• Turmeric and ginger – have anti-inflammatory properties.
• Slippery elm powder – creates a soothing barrier along the walls of the intestines thus aiding the passage of food and reducing irritation.
• Fish oils – provide omega 3 fats which are anti-inflammatory and healing.

It is advisable to consult a practitioner about which of these supplements maybe useful for any individual and at which stage each should be introduced. It is important to check the label to ensure supplements do not contain sugars such as fructose, sorbitol, lactose and inulin which need to be avoided while following the low FODMAP regime.