Abstract Food intolerances in irritable bowel syndrome (IBS) are becoming more recognised. Patients are convinced that diet plays a role in inducing symptoms. Many patients with IBS report improved symptoms on a gluten-free diet, yet this has until recently been unstudied. While this is conceivable, the available evidence of a relationship between a low-chemical diet and IBS is lacking.
There is a possibility that a low-chemical food diet may ameliorate symptoms of IBS. Through an effect on levels of luminal distension hypersensitivity, but more work is needed. If your nutritionist suspects a food chemical intolerance might contribute to your symptoms, they might recommend the RPAH diet instead. It involves elimination and a challenging phase for food chemicals, additives, and preservatives. The RPAH diet must be overseen by a qualified practising dietitian who has expertise in food chemical intolerances.
RPAH has developed a specific elimination diet to investigate and manage suspected food sensitivities. Our full credentialed Dietitian and Nutritionists are trained in implementing RPAHs Food Elimination Diet. After consulting with your dietitian or consulting with the RPAH elimination diet handbook, depending on your symptoms, you may choose to go with a strict, moderate, or easy version of the FAILSAFE diet.
If you are experiencing symptoms of food intolerance not related to digestive issues, and have been tested for allergies, then the FAILSAFE diet may be something to consider. FODMAP are most likely causing digestive issues, and you should exclude them before trying a FAILSAFE diet. Some foods that are low in natural food chemicals are also high in FODMAP, so while FODMAP and food chemicals may cause similar symptoms, it may be hard at times to decide which elimination diet is best.
Certain foods may trigger symptoms of IBS, even when they are not excluded from a low-FODMAP or elimination RPAH diet. The FODMAP diet helps to identify whether or not these carbohydrates are responsible for triggering symptoms for people with IBS. The largest evidence base is on a food-chemical elimination diet recommended by IBS dietitian. The substantial body of evidence supporting a low-fodmap diet for IBS, as well as the fact that it is relatively simple to implement with no major dietary concerns, supports the recommendation that this should be the first diet intervention tested on patients presenting with IBS.
For instance, it has been suggested that patients with IBS and a history of allergies. Those with other conditions suggesting sensitivity to dietary chemicals i.e., asthma, eczema, rhinitis may have better responses to the diet without chemical food products. Although, it has never been studied in any formal way. Whereas an elimination diet is designed to determine whether or not the person’s symptoms are caused by chemicals found in foods, not carbohydrates. An elimination diet is a tool that can be used to evaluate whether specific foods are contributing to symptoms of Irritable Bowel Syndrome (IBS).
The only accurate way of determining dietary intolerances to naturally occurring and added food chemicals is through an elimination/failsafe diet, a type of RPAH, that is followed by a challenge of specific foods to identify the chemicals responsible for producing symptoms. A nutritionist specialising in IBS told us she generally finds that food chemicals are a major problem with IBS, and the RPAH Diet is what she uses the most. A few dietitian that are using an RPAH elimination diet as their IBS treatment even before looking into FODMAPs. However, they feel that this is more effective than FODMAPs based on what they see in practice.
There are reports from people just like you, who do not find FODMAPs working, or worsen their condition, then doing very well with the RPAH diet. Unfortunately, there is a lot of misinformation on the low-FODMAP diet online. The wider population often go on diets that are unnecessarily restrictive or reduce the wrong foods. Low FODMAP diets are often the first diets that are tried to manage IBS (irritable bowel syndrome). Some people may not experience the relief that they are hoping for from this diet. They may believe that there might be other food sensitivities lurking. Some people sensitive to food chemicals often will initially experience some relief from starting the Low FODMAP diet.
When the low FODMAP diet starts expanding over time as you build up your confidence. Certain other foods can sneak back onto your daily eating plans and contribute to the worsening of symptoms. If your symptoms are not improving, it is important to reintroduce all the high FODMAP foods back into your diet. Foods with FODMAPs are important sources of prebiotic fibres, which positively affect gut health. Studies show up to 75% of IBS sufferers may benefit from following a low FODMAP diet. When done with guidance from a qualified, accredited practising dietitian.