Hi Friends! Happy start to the HOLIDAYS!
I can’t believe Thanksgiving is just around the corner. How did that happen??? Since I last wrote a blog post, my husband came back from Alaska (yay!) and I launched a new website along with Angela Pfifer, called GutRx Gurus!! And most recently...I was in Kauai for some much needed relaxation and rejuvenation....NOW I AM BACK!
The launch of GutRx Gurus has been really exciting, although also nerve racking. With a few bumps along the way, Angela and I were able to launch in late September. Collectively we are Angela, Selva, and Rebecca, each with our own unique expertise in functional gut disorders. Angela, a Seattle based certified nutritionist, has worked with many SIBO patients over the last few years and has specialized in this functional gut disorder. Rebecca on the other hand was a SIBO patient herself in Australia and has created many delicious SIBO friendly recipes and cookbooks. And myself, as local Bellingham private practice and clinical dietitian, am also seeing IBS/SIBO patients guiding them through the low FODMAP diet and offering individual nutrition therapy. So between the three of us, we have a lot of information, a lot of tasty low FODMAP approved recipes, cooking videos, an easy to use recipe manager and personalized shopping lists, as well as a forum for members. In addition, every month a Guest Guru (other dietitians/nutritionists, NDs/MDs, and low FODMAP bloggers) provide their tasty recipes along with some new information. So come check us out!!
So what is IBS and what is SIBO?
IBS or otherwise known as irritable bowel syndrome, can be characterized by chronic diarrhea, constipation, or a mix of both. This may also include gas, bloating, intolerance to certain foods, etc.
SIBO, or otherwise known as small intestinal bacterial overgrowth, is often associated with IBS patients. SIBO occurs when the bacteria from the large intestine migrate up to the small intestine, causing severe GI distress including painful gas and bloating. Many things such as slow transit time (the time it takes until elimination), decreased stomach acid (due to stress, proton pump inhibitors, and old age), chronic use of antibiotics, gastric surgery, and reduced function of the ileocecal valve may contribute to the onset of SIBO.
Although an antibiotic or herbal antibiotic protocol is required to treat SIBO, the low FODMAP diet can provide symptom relief for many SIBO and IBS patients.
What is FODMAP?
FODMAPs (Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides and Polyols) are a large group of carbohydrates that are poorly absorbed in the small intestine and are rapidly fermented by gut bacteria as fuel. When all things are good, this fermentation happens in the colon, which is designed to expand and handle the gas that is produced. These sugars are GOOD when the bacteria are in the right place. However, when the bacteria have migrated up to the small intestine, which is not designed to stretch and hold large amounts of gas like the colon, we get painful gas build up and bloating.
What is each FODMAP category specifically?
Oligo-saccharides are prebiotics. You may have heard that prebiotics help fuel good gut bacteria. And this is true! However, in the case of FODMAP sensitive individuals, it feeds the gut bacteria in the wrong place and causes severe GI distress. The two categories of oligo-saccharides are fructans (ie: garlic and onions) and galactans (beans and legumes), which often cause distress in individuals sensitive to FODMAPS.
Lactose is the sugar in the disaccharide category, which many people may already eliminate based on their intolerance to lactose. Therefore, drinking lactose free beverages, or low lactose foods such as homemade yogurt or ghee, can be well tolerated.
Fructose is the sugar in the monosaccharide category, which includes high fructose corn syrup, agave syrup, mango, honey, apples, pears, etc. Interestingly, glucose aids in the absorption of fructose. Therefore, foods that contain a balanced ratio of glucose to fructose are better tolerated.
Polyols are known as sugar alcohols, which are often hidden in sugar free products. Sorbitol and xylitol are two examples. However, it is also found naturally in some fruits, such as blackberries, lychees, peaches, and more.
By following a LOW FODMAP diet you remove the carbohydrates and fibers that feed the bacteria in the small intestine. However, this is only meant to be a short term diet. Usually I recommend patients remove all FODMAP foods for 1 month, and then begin to challenge each individual category using a specific food item in a specific amount. Reintroduction may take some time, but this will allow for increased variety in the diet. A LOW FODMAP diet is not ideal to follow for the long term. However, some individuals may need to follow a modified FODMAP diet based on the foods that they are sensitive to for a longer period of time or indefinitely. See the Monash University Low FODMAP app for a detailed list of foods high and low in FODMAPS.
So to keep this short and sweet….that's it for today…..I will most likely write more about gut health, SIBO, IBS, and FODMAPS in the future.
Below you will find a LOW FODMAP bone broth rich in easy to digest proteins and minerals. Drink 1 cup a day for gut health. For a regular bone broth, see this recipe post! Plus, as the holidays are now creeping in on us...a hearty bone broth can come in handy in many more ways than just for gut health. Use this flavorful base in your favorite fall soups, stews, braise meats or veggies in broth for enhanced flavor, for flavorful sauces and gravies, and or drink as is!
Easy Low FODMAP Slow Cooker Beef Bone Broth
Makes ~4 quarts
2lbs beef marrow bones (grass fed)
2 carrots, cut into quarters
1 medium parsnip, cut into quarters (optional)
1/2 small celeriac root, cut in half
½ bunch flat leafed parsley
1 bay leaf
1 whole clove
5 whole peppercorns
1 tablespoon apple cider vinegar
Preheat oven to 400 degrees Fahrenheit. Place bones on a baking sheet and roast for 30-45 min, turning every 20-30 minutes until browned.
Add the roasted beef bones to the slow-cooker. Pierce the bay leaf to celeriac root with the clove. Add all the veggies and remaining spice to the bones. Fill up with enough fresh filtered water to cover the bones. Program slow-cooker to cook on low for 10 hours. Remove the veggies after 10 hours and discard. Fill with more filtered water to cover bones and continue to cook on low for an additional 10+ hours if a stronger more medicinal bone broth is desired. I recommend a 24-30 hour total simmer time.
When the broth is ready pour the remaining liquid into large glass jars and cool to keep it from souring. Once cooled, you may remove as much of the fat layer as desired. The remaining broth can be thinned with water if necessary. This broth keeps for 1 week in the refrigerator or freeze in ice cube trays for later use. Season with sea salt and/or fresh herbs if used as a hot beverage.
Note: Alternatively, you can keep the bones in the slow cooker and continue to replace the broth that is used with some fresh water. Keep simmering on low. You may repeat this for up to 5-7 days or until the broth lacks flavor. Then discard.