Chris Kresser, on his 11/1/2011 podcast (link starting at 44:40 or so) suggested that you could cure or at least mitigate FODMAP intolerance. Quote:
FODMAP intolerance is a sign of a deeper issue. I think it's probably a consequence of small-bowel bacteria overgrowth or any other kind of dysregulation of the gut flora, which could also include a pathogen like a parasite or yeast or pathogenic bacteria.
He uses the FODMAP diet as a temporary symptom relief while working on the underlying problem, and then some level of FODMAPs can be re-introduced after the problem is resolved.
If you deal with the dysregulated gut flora, you usually can re-integrate some of those foods. Not always, but in most cases in my practice. That would include dealing with the pathogen as one step, but also restoring healthy gut flora using probiotics is another.
Ok. My questions for the hive mind:
1) Is this something that could be attempted at home, or should one really find a practitioner to work through?
1a) If the right answer is to work with a practitioner, how would one go about finding a competent one?
2) What's the protocol for doing dealing with dysregulated gut flora? Most reports I read on the Internets indicate some level of floundering, trial-and-error, and success or failure without any real knowledge about why something worked or didn't work.
3) Which probiotics are the right ones? I'm reading reports of the ~1000 strains of gut bacteria, which ones are a) the right ones to add or support, and b) are those strains available for purchase or ...?
4) Any credibility to the idea of home fermentation of FODMAP containing products (a nice relish of lacto-fermented onions and peppers actually sounds pretty tasty to me) as perhaps a particularly good way to introduce FODMAP-digesting bacteria to the gut?
Is he speculating, or does he actually describe examples of folks who have mitigated/cured their FODMAP intolerance? (Sorry, I can't stand audio--I need to read it!)
My n=1 experience (after 1 year of 99% lacto-Paleo) is that I can do very small amounts of high FODMAP foods, but not too much or I get symptoms.
I eat plenty of fermented foods daily, and my gut health is great (from what I can see!)
I used to have FODMAP intolerance and SIBO and although I still need to be careful with my diet, I have A LOT more flexibility with my food choices than I used to have. I can now enjoy almost any vegetables, including onions, broccoli and asparagus without any problems! SOme of my journey is described on my blog adietitiangonepaleo.
I think that eliminating FODMAPs to allow your gut to heal and your gut flora to rebalance itself can make a BIG difference.
I just wrote an article about the Paleo diet & FODMAPs. You will also find a downloadable PDF list of FODMAP Paleo food choices.
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