# FODMAPs in Accutane capsules. Can I do anything?



## oscillate.wildly (May 19, 2013)

Hi everyone,

I started the FODMAP diet about 3 weeks ago for IBS-C and have seen some improvements. Not totally better but certainly not as much pain, although still quite bloated and some days like today with mild discomfort all day. It is definitely helping though, even if it just comes down to not stuffing myself with vegetables (god I miss them!!!) and (although it sounds crazy) broadening my diet in terms of fats and oils (something I usually avoid). I hope to start the challenges in a few weeks, if not sooner.

Anyway, I have worsening and scarring cystic acne and have has to start a course of Accutane (isotretinoin) a week ago.
The capsules contain 85% glycerol, plus karion 83 containing sorbitol, mannitol, hydrogenated hydrolysed starch, with sorbitol (E420). Full list here: http://goo.gl/D9FAa
I take one capsule a day so far, but will have to increase to 2 next week 

Could this wreck my FODMAP diet? I do feel like I get symptoms after taking the drug, but hard to tell as I have to take it with my evening meal and I usually get quite bloated after eating my main meal. I have IBS-C and whilst my constipation has really improved following starting the diet and being more regular with a low dose of laxative (laxido once a day), I still feel like my bowels are always full and adding food to my stomach results in a giant food baby. It's hard to describe - I am quite slim all over with not much fat on my belly, but it is like I can't even 'suck in' my tummy because my bowels are so full.

Anyway, some advice regarding Accutane and the polyols included would be brilliant. Is there anything I can do to counteract them, e.g. like the solution of taking glucose with fructose? Is there a trick for polyols?

Thanks so much everyone

Emma

p.s. does anyone have any advice on whether oat bran (great source of fiber) is good or bad for IBS-C? I thought it was a good source of soluble fiber but I am not sure if it is helping.


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## Kathleen M. (Nov 16, 1999)

People usually can tolerate a small amount of fodmaps every day. There isn't a lot of anything in a pill, so the total amount added should be very small.

You may want to watch the amount of other fodmaps you add back in as the total amount matters.

Remember you can only make a couple of molecules of gas from a couple of molecules of fodmap, so it isn't like an immune response where even one molecule can create a huge reaction.

FWIW Sorbitol is a laxative as well as making gas so shouldn't be as much of a concern for someone who is conatipated as it won't make you more constipated.

While oat bran is a good source of soluble fiber you may need to play around with the amount to see if what you are doing is enough or if you tolerate the fiber. There isn't a good way to predict who needs exactly X number of grams type of thing.


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## LivingHappyWithIBS (May 22, 2013)

I would be wary of Accutane in general. I took it years ago and I think it contributed to my issues. While it has not been proven, it's something to consider. Here's more info on the subject: http://ibdcrohns.about.com/od/ulcerativecolitis/f/Do-Acne-Drugs-Cause-Ibd.htm.

Sorbitol and mannitol are big issues for me, even in the smallest quantities. However, I have IBS-D, so it may have different effects on you.


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