Why is my stomach so bloated and painful?

Bridgette, 35 an architect was a single mom and had a busy an active professional and personal life. 

Some two years ago she had caught MONO and had to receive a large dose of antibiotics that had thankfully put her symptoms into remission. Two months later she noticed some unusual digestive symptoms. She experienced abdominal pain and cramping, which was relieved by going to the bathroom. Her tummy was often bloated and swollen. Her bowel habits changed and would alternate between diarrhea and constipation (several days without having a bowel motion). She occasionally had an urgent need to go to the bathroom, and she sometimes had a feeling that she could not fully empty her bowels after going to the toilet.
Being health conscious, she quickly decided to visit her family physician who immediately diagnosed her with irritable bowel syndrome (IBS). 

The usual standard of care for IBS are four types of medication, which only control symptoms, including: 

• An antispasmodic (which helps reduce abdominal (stomach) pain and cramping).
• A laxative (to help relieve constipation).
• An antimotility medicine (to can help relieve diarrhoea).
• A low-dose Antidepressant (to help reduce stomach pain and cramping).

Like most people, Bridgitte was exceptionally wary of taking any medication because of the potential side effects, and they do not address the underlying cause.

Not happy with this approach Bridgette wisely stood her ground and asked to see a Gastroenterologist, a doctor who specializes in digestive issues. Her doctor agreed and arranged an appointment for a week later.

At the meeting, the consultant went over her symptoms and agreed with her doctor's diagnosis of IBS. He also listened to her concerns about taking medication and her need to find a more natural solution to which he said he was more inclined to with patients under his care.

He suggested that Bridgette follows a Low FodMap Diet.

FodMap (Fermentable Oligo-Di-Monosaccharides and Polyols) are carbohydrates that found in certain foods. A low Fodmap diet has been shown to reduce symptoms in 75% of people with IBS. (1) 

FODMAPs in the diet are:

• Fructose (fruits, honey, high fructose corn syrup (HFCS), etc)
• Lactose (dairy)
• Fructans (wheat, garlic, onion, inulin etc)
• Galactans (legumes such as beans, lentils, soybeans, etc)
• Polyols (sweeteners containing isomalt, mannitol, sorbitol, xylitol, stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums, etc)

Bridgette began the low Fodmap diet the next day and within 2-3 days felt 80% improvement in her symptoms.

Following a low Fodmap diet will help relieve many of the symptoms of IBS but like the medication it does not address the cause.

So why do people become intolerant to Fodmaps?

Recent scientific research has identified a link between IBS and Small Intestinal Bacterial Overgrowth (SIBO). (2) Your friendly bacteria should predominantly be living in your large intestines, with SIBO, these bacteria migrate up into the small intestines. These bacteria feed on Fodmaps and when they do they produce different gases causing the bloating, constipation, diarrhea, gas and abdominal pain. You can test for SIBO using a simple breath test and then treatment can be a combination of antimicrobials and diet.
Emotional factors have also been shown to contribute to the development of IBS, and could induce a Fodmap intolerance for reasons not yet understood.
When dealing with any condition, including IBS, it is always important to look at diet but also lifestyle factors including stress management, exercise, and sleep. If you correct one factor without addressing the others, this often results in a poor outcome.

Finally

I hope you found these ideas useful. More importantly, I hope you do something with them.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.