Even the thought of the reintroduction phase of the low-FODMAP diet can be daunting!
And it is tempting to hide your head under a pillow and just pretend high-FODMAP foods don’t exist. However, it’s important to remember that these foods are beneficial for long-term gut health. So, is it time for you to reintroduce?
Trust me I know that you would prefer to stay in your symptom free or low-symptom bubble, and that the thought of having a reaction to high-FODMAP foods is terrifying. Keep in mind that you would have to be very unlucky, or have other underlying medical conditions, to be highly sensitive to all of the FODMAP groups.
This means you might be missing out on enjoying some delicious foods! I will be starting to re-challenge and test the FODMAP groups soon (I’m actually excited!) so let’s talk about how to reduce anxiety, and gear up for reintroduction.
Are you ready to reintroduce?
If you are currently enjoying a settled period of gastrointestinal symptoms after 2 to 6 weeks on a strict low-FODMAP diet, then it is time to start reintroducing. Expecting to always be completely symptom free is unrealistic, especially as stress, illness, life events, and eating patterns can all affect irritable bowel syndrome, and influence gastrointestinal symptoms. This means if you are only experiencing the occasional hiccup, or very mild symptoms, then you can start exploring the reintroduction challenges (ideally with the help of a FODMAP-trained dietitian).
If you are still experiencing a significant number of gastrointestinal symptoms after four weeks on a strict low-FODMAP diet, then it might be time to talk to a FODMAP-trained dietitian and to start troubleshooting. To help with the troubleshooting process, check out my article on the common reasons why the low-FODMAP diet might not be working, and dietitian Joanna Baker’s article on five reasons the low-FODMAP diet might not be working.
Seeking reintroduction help
Ideally the reintroduction phase should be completed with the guidance of a FODMAP-trained dietitian. This is so they can tailor the challenges to suit your eating habits and choose portion sizes that are less daunting and more realistic for your body. If you don’t have access to a FODMAP-trained dietitian then you might find my reintroduction phase article, and dietitian Lee Martin’s guide to reintroducing FODMAPs helpful.
It is likely that at some point during your FODMAP re-challenge tests you will experience symptoms. Getting prepared by creating a FODMAP emergency kit can help reduce your anxiety and manage your symptoms. I like to keep these products handy:
- Peppermint oil capsules or peppermint tea to help reduce bowel spasms (cramps)
- Ginger to help with nausea
- Over the counter medications like anti-diarrhoea medication (eg Imodium), antispasmodics (eg Buscopan), and anti-gas medication to take as needed
- Heat pack for comfort and to help relieve pain
- Fibre supplement and laxative. Constipation is not normally my issue, but if it is for you then having these on hand can be helpful.
The fear of having a FODMAP reaction at work can be a major hurdle for many people. So, talk to your dietitian about if it is appropriate to start the first day of your re-challenge tests on a Friday night. That way if it all goes pear-shaped in the first 24 hours you still have a day to recover before heading back to work.
Once you have started your re-challenge test try to relax (I know this is hard to do!). Stress by itself can trigger IBS symptoms. If you can, try to be mindful and relaxed, and let your digestive system process the FODMAP without adding additional pressure. Also remember that everyone’s digestive system can get a little bit gurgly or noisy at times, and it is completely normal to experience a small amount of gas or mild bloating. Any symptoms that cause pain or more than mild discomfort indicate a FODMAP reaction. Try and focus on the positive. If you pass the test you get to add more yummy foods back into your diet.
Surviving gastrointestinal distress
This is never ever pleasant but you will probably experience gastrointestinal distress at some point during your FODMAP re-challenge tests. First things first – don’t panic! You already have your FODMAP emergency kit prepared if you need it. Revert back to the strict low-FODMAP diet so you don’t overload your system with more FODMAPs. Drink lots of water and stay hydrated.
Try and take comfort in the fact that you have successfully identified a trigger food, and go back to focusing on what you can eat. Take time to rest and recover until your symptoms resolve. Be gentle with yourself. You haven’t ‘failed’, instead you now have a better understanding of how your body reacts to this FODMAP group.
The reintroduction phase of the low-FODMAP diet can be both a daunting and an exciting time. There are plenty of steps you can take to reduce your anxiety levels around reintroducing high-FODMAP foods. My top tip is to focus on the positive, by the end of the test you will know what foods you can add back in, and what FODMAP groups are definitely symptom triggers. For information on Five Common Reintroduction Mistakes, check out this article.