FODMAP Intolerance and Pregnancy

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Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic FODMAP Intolerance, go here. For the topic Irritable Bowel Syndrome, go here. These expert reports are free of charge and can be saved and shared.

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For the past few years, Katrina had been having trouble with her belly. Eating, along with stress, brought with it cramps, bloating, and gas. She went to her doctor and, after a full work-up, she was diagnosed with irritable bowel syndrome (IBS). To manage it, her doctor suggested she follow a low-FODMAP diet. She has been following the diet for a few months and has been feeling a little better.

What are FODMAPs?

FODMAPs are Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. They are easily fermentable, short-chain carbohydrates that some people find difficult to digest. They can cause bloating and diarrhea because they tend to pull water into the intestines. The gas comes when they ferment in your digestive tract.

Not everyone is sensitive to FODMAPs. Some people can be affected to different degrees by these specific carbohydrates. Additionally, a person can be sensitive to some, but not all of the FODMAPs.

Specific sugars and foods associated with FODMAPs:

  • Oligosaccharides include galacto-oligosaccharides and fructans. Galacto-oligosaccharides can be found in foods like lentils, chickpeas, and broccoli. Fructans are also found in broccoli as well as in garlic and onions, wheat and rye, and in inulin, which can be added to food to increase dietary fiber or used as a sweetener.
  • Disaccharides include lactose, which is in milk, yogurt, soft cheeses, and other dairy products.
  • Monosaccharides are the fructose sugar found in fruits like apples, pears, and watermelon. Additionally, fructose can be found in natural sweeteners like honey and agave nectar. Finally, check the labels for high-fructose corn syrup, because those bothersome monosaccharides can be found there too.
  • Polyols can be found in fruits like apples, blackberries, cherries, and avocados. They can also be found in vegetables like cauliflower. It might be helpful to check the label on your sugar-free gum or candy for artificial sweeteners like sorbitol, mannitol, or xylitol.

What is a Low-FODMAP Diet?

When you first start a low-FODMAP dietary plan, your doctor or dietician will likely instruct you to cut out as many FODMAPs as possible and monitor your symptoms. If you find restricting your diet has improved your symptoms, you can add back foods one at a time and keep track of which foods cause which symptoms. In this way, you can control your IBS instead of the other way around.

FODMAPs and Pregnancy

A few months after Katrina got her IBS symptoms under control, she found out that she and her partner had been successful in conceiving. Katrina was pregnant! She was very happy about this, but at the same time, she was concerned. She knew her caloric requirements would be increasing to support her pregnancy. This made her worried about including more foods containing FODMAPs into her diet. Furthermore, she began feeling morning sickness. Some lucky IBS sufferers notice their symptoms improve during pregnancy. Unfortunately, Katrina was not one of the lucky ones. In other words, her belly was all messed up again.

Nutritional needs change during pregnancy. It’s very important you give your body and your developing fetus what they need to grow and be healthy. If you are having IBS symptoms during pregnancy, you should visit a dietitian to get the support you need.

Eating During Pregnancy and Breastfeeding

Eating during pregnancy is often a game of trial and error. While experiencing a mix of overwhelming food cravings and intense food aversions, along with morning sickness, you also have to keep in mind the nutritional needs of both momma and developing baby. Our bodies are pretty good at telling us what we need to eat during this time.

If you have found your IBS symptoms are persisting or worsening in pregnancy, you can try to eat low FODMAP foods that pack a high nutritional impact, like bananas, lactose-free yogurt, chicken, and quinoa. You can even treat yourself to some chocolate (dark chocolate is a good choice).

There is also the option to take digestive enzyme supplement pills before eating certain foods. Because these stay in the digestive tract to work on the food that you’ve eaten, there is no risk to baby. However, it’s best to check with your doctor before taking any medication. More information is available in Pregistry’s Expert Report on FODMAP Intolerance.

Through experimentation, and under the supervision of her dietitian and physician, Katrina found a diet that worked for her throughout her pregnancy. She gave birth to a healthy baby and is continuing on her eating plan, taking care to eat foods that pack a nutritional punch without upsetting her belly, and eating enough calories while she breastfeeds her newborn.

Janette DeFelice
Dr. Janette DeFelice is a writer currently focusing on how the changing environment affects our health. She holds a Doctor of Medicine degree from Chicago Medical School where she taught clinical and diagnostic skills to beginning medical students, and a Master’s degree in Humanities from the University of Chicago. She also has a Bachelor’s degree in Political Science. Her writing can be seen online at BeTheChangeMom, ChicagoNow, and Medium, and she’s very excited to have published her first novel, Delia Rising: A Ballet in Three Acts. She lives in Chicago’s west suburbs with her school-age twins, her husband, and a family cat named Clara Barton.

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