FODMAPs are carbohydrates that have been linked to symptoms like abdominal pain, diarrhea, and constipation, especially in patients with Irritable Bowel Syndrome (IBS).
If you have IBS and are wondering how quickly FODMAPs might send you to the washroom, you’ve come to the right place. We’ll take a look at some basic gut physiology and some conditions (other than IBS) that you may have if you find yourself running to the bathroom immediately after a meal.
What are FODMAPs?
FODMAP stands for fermentable oligo-, di-, mono-saccharides and polyols. They are basically short-chain sugars found naturally in diet. Examples include:
- Fructose — found in fruits and vegetable as well as table sugar
- Galactans — found in legumes
- Lactose — found in dairy products
- Fructans — present in grains like wheat, rye, and barley
- Polyols — can be found in fruits and vegetables as well as sweeteners
FODMAPs are resistant to digestion, which means they reach all the way to the large intestine. This is the reason they can trigger abdominal symptoms, so let’s discuss how they do that.
Why are FODMAPs bad?
The food you eat is digested in the small intestine. Undigested food makes its way to the large intestine, where in addition to meeting a huge colony of bacteria, it’s stored for excretion.
FODMAPs can trigger IBS symptoms in two ways. The first is via osmotic pull of water. The lining of your gut is permeable to water and FODMAPs can increase the amount of water in the gut. This can lead to diarrhea.
The second way is fermentation. Since FODMAPs are resistant to digestion, they easily make their way to the large intestine. Here, they meet bacteria, which feed on the sugars and release gas. This gas can trigger symptoms like bloating, cramping, and abdominal pain. People with IBS have an increased gut sensitivity, so even a small amount of gas can cause considerable discomfort.
The digestive process
There are normal time periods food takes to move along the various segments of your GI tract, and this may help us understand how quickly FODMAPs affect us. Food enters your stomach immediately after you eat, but this is not where FODMAP reactions occur.
Once food enters the stomach, it can take up to 6-8 hours for it to journey all the way through the stomach and the small bowel. It;s in the small intestine that various enzymes break down large molecules in food into smaller ones for absorption. Unabsorbed food (like FODMAPs) and water then enters the large intestine.
In the large intestine, food can take around 36 hours to completely traverse it. Depending on the individual, the whole process of digestion can take up to 2-5 days.
How quickly do FODMAPs affect you?
How quickly FODMAPs affect you depends on the mechanism that gets activated to trigger your symptoms.
The classical mechanism is gas release via fermentation, and this can take anywhere from 2 to 8 hours to trigger symptoms. 2 hours is not typical and usually occurs if your diet has too many FODMAPs. A good estimate for the typical period would be 4-5 hours.
Some patients complain that they have to go to the toilet immediately after eating. It’s unlikely that FODMAPs cause this via fermentation. That’s because on average, it takes about 12 to 48 hours for food to move from the mouth to the anus (the last part of the gut) in healthy people. This means something other than fermentation is at play if you need to evacuate your bowel immediately after eating.
The most likely explanation for this is an accelerated gastrocolic reflex (GCR), which is common in IBS. Normally, when you eat food, hormones like cholecystokinin and secretin are secreted by the gastrointestinal system. Nerve signals are also generated as a result of stomach stretching. All of this tells the food in your gut to “move along a bit” so the incoming food can be accommodated. This is why we often pass stools after eating a meal and not randomly.
People with IBS can have an accelerated GCR, so much so that massive amounts of food can be pushed into the large intestine upon eating. If what you ate yesterday was rich in FODMAPs, now could be the time it triggers your IBS symptoms.
So in essence, it’s not the FODMAPs in your current meal that send you rushing to the bathroom but FODMAPs in a meal you took several hours or a day earlier.
There are some other conditions that can trigger abdominal symptoms immediately after eating and may be mistaken for an accelerated GCR or FODMAP-allergy. These include classic food allergy, sulfite sensitivity, and histamine intolerance.
Classic food allergy
In classic food allergy, your body has high circulating levels of IgE (a protein that triggers allergic reactions) against a food protein. Your body recognizes this protein as foreign and symptoms like stomach pain, diarrhea, and vomiting may be triggered immediately after eating it.
Sulfite sensitivity is similar to food allergy and in this case, the body reacts vigorously against food additives called sulfites. Foods preserved with sulfites can include alcohol, red wine, and a range of frozen items.
In addition to abdominal symptoms, patients may develop a generalized allergic reaction characterized by asthma and hives (raised skin lesions).
Histamine intolerance is similar to sulfite sensitivity, except that this time the body reacts violently to foods that are high in a compound called histamine.
Examples include spinach, aged cheese, and tomatoes.
How to do a low-FODMAP diet?
A low-FODMAP diet is done under expert supervision where all FODMAPs are eliminated from the diet initially. This is followed by gradual reintroduction to catch the culprit that has been causing your symptoms.
If you feel your IBS is triggered by FODMAPs (and not some of the other conditions mentioned above), a low-FODMAP diet may be very helpful.
During the initial elimination phase, you’d want to avoid the following high-FODMAP foods:
- High FODMAP fruits
- Dairy products
- Vegetables like broccoli, Brussel sprouts, and cabbage
- Grains like wheat and barley
- Fruit juices
- Soy milk
- Most wheat-based foods
The list goes on, and it’s best to consult a doctor for a comprehensive elimination plan. You can see that the low-FODMAP diet is very restrictive. If done without a doctor’s supervision, it can easily lead to nutritional deficiencies.
If your abdominal symptoms get triggered immediately after eating a meal, it’s unlikely to be due to FODMAP fermentation. FODMAP fermentation takes about 2-8 hours to cause symptoms. If you have IBS, however, you may have an accelerated GCR. In that case, FODMAPs may trigger symptoms immediately.
Other conditions like histamine intolerance and food allergy may be behind immediate triggering of symptoms, so it’s important to rule those out with a doctor first.
Medically Reviewed by Onikepe Adegbola, MD PhD