Common Gut Problems: Could a Specialist Dietitian Help You?

Introduction If you have been diagnosed with IBS or have been researching ways to manage your digestive symptoms, you have almost certainly come across the low FODMAP diet. It is widely recommended, frequently discussed online, and has a strong body of clinical evidence behind it. But it is also one of the most misunderstood dietary approaches in gut health, and following it incorrectly can do more harm than good. Here is what the low FODMAP diet actually involves, who it is suitable for, and why working with a specialist dietitian makes a significant difference to your results. What Are FODMAPs? FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. These are a group of short-chain carbohydrates found in a wide range of everyday foods that are poorly absorbed in the small intestine. When they reach the large intestine, they are fermented by gut bacteria, producing gas and drawing water into the bowel. In people with IBS, this process can trigger symptoms including bloating, abdominal pain, diarrhoea, and constipation. High FODMAP foods include wheat, onions, garlic, certain fruits such as apples and mangoes, dairy products containing lactose, legumes, and some artificial sweeteners. Low FODMAP alternatives exist for most food groups, meaning the diet can be nutritionally complete when followed correctly. How the Diet Works The low FODMAP diet is not a permanent diet. It is a structured three-phase process designed to identify your individual food triggers so that your long-term diet can be as varied and unrestricted as possible. The first phase involves eliminating all high FODMAP foods for a period of two to six weeks. If symptoms improve, this confirms that FODMAPs are contributing to your symptoms. The second phase involves systematically reintroducing individual FODMAP groups one at a time to identify which specific foods trigger your symptoms. The third phase involves personalising your long-term diet based on your individual tolerances, so that you are only avoiding the foods that actually affect you. Why You Should Not Do It Alone The low FODMAP diet is one of the most complex dietary protocols in clinical nutrition. The list of high and low FODMAP foods is extensive and counterintuitive in places, portion sizes matter as much as food choices, and the reintroduction phase requires careful planning to produce meaningful results. Research consistently shows that people who follow the low FODMAP diet with the support of a trained dietitian achieve significantly better outcomes than those who attempt it independently. Without proper guidance, many people remain on the restrictive elimination phase indefinitely, which can lead to nutritional deficiencies, an unnecessarily limited diet, and a negative relationship with food. Is the Low FODMAP Diet Right for You? The low FODMAP diet is not appropriate for everyone with gut symptoms. It is most suitable for people with a confirmed diagnosis of IBS who have not responded adequately to first-line dietary advice. It is not recommended as a first step for people with a history of disordered eating, those who are underweight, or those whose symptoms may have an underlying cause that has not yet been investigated. A specialist assessment will help determine whether the low FODMAP diet is the right approach for you, or whether a different dietary strategy would be more appropriate for your individual situation. If you would like to find out more or to book an appointment, get in touch with GutSense Clinic today.

Introduction Irritable bowel syndrome is one of the most common diagnoses given to people experiencing persistent digestive symptoms. For many patients, the diagnosis comes after other conditions have been ruled out, and while IBS is a genuine and often debilitating condition, it is also frequently used as a catch-all label when the true underlying cause has not yet been identified. If you have been told you have IBS but continue to struggle with symptoms despite dietary changes, it may be worth exploring whether something else is contributing to how you feel. The Problem With IBS as a Diagnosis IBS is what is known as a functional diagnosis, meaning it describes a pattern of symptoms rather than a specific structural or biochemical abnormality. This is not a criticism of the diagnosis itself, but it does mean that the label alone does not tell you why you are experiencing symptoms or what is driving them. Several conditions can present with symptoms that closely mimic IBS, and in some cases these conditions go undiagnosed for years while patients manage what they believe to be straightforward IBS. Conditions That Are Commonly Mistaken for IBS Small Intestinal Bacterial Overgrowth (SIBO) SIBO is now recognised as a significant underlying cause of IBS-like symptoms, particularly bloating, excessive wind, and diarrhoea. Studies suggest that a substantial proportion of people diagnosed with IBS may actually have SIBO. It can be identified through a breath test and responds well to targeted dietary and medical treatment. Coeliac Disease Coeliac disease can present with bloating, diarrhoea, abdominal pain, and fatigue, all symptoms that overlap closely with IBS. It is estimated that a significant number of people with coeliac disease remain undiagnosed. A simple blood test can screen for it, and a definitive diagnosis is made through a gut biopsy. Bile Acid Malabsorption This is one of the most commonly overlooked causes of chronic diarrhoea. Bile acid malabsorption occurs when bile acids are not properly reabsorbed in the small intestine and pass into the colon, causing watery diarrhoea. It is often misdiagnosed as IBS-D (diarrhoea-predominant IBS) and can be identified through a SeHCAT scan or a trial of bile acid sequestrant medication. Food Allergies and Intolerances Lactose intolerance, fructose malabsorption, and non-coeliac gluten sensitivity can all cause digestive symptoms that look like IBS. Identifying these through proper dietary assessment and testing, rather than self-directed elimination, ensures that any dietary restrictions are both necessary and nutritionally safe. When Should You Seek a Specialist Assessment? If any of the following apply to you, it is worth seeking a specialist dietetic assessment rather than continuing to manage symptoms on your own: You have been diagnosed with IBS but have not seen significant improvement with standard dietary advice. Your symptoms include persistent or unexplained diarrhoea. You have unintended weight loss, fatigue, or signs of nutritional deficiency alongside your gut symptoms. You have a family history of coeliac disease or inflammatory bowel disease. You have tried the low FODMAP diet without success. What a Specialist Assessment Involves At GutSense Clinic, every assessment begins with a thorough review of your symptoms, medical history, dietary intake, and any previous investigations. From there, Jeanette will work with you to identify whether further testing is appropriate, develop a personalised dietary plan, and provide the ongoing support you need to see real, lasting improvement. Getting the right diagnosis is not just about having a label. It is about understanding what is happening in your body so that treatment can be targeted, effective, and sustainable. If you are ready to get some proper answers, book an appointment today.