# FODMAP: wheat and lactose. I'm so confused :(



## oscillate.wildly (May 19, 2013)

Hi everyone,

I'm new here but have been following for a while. I'm wondering if anyone could help me.

I am 27 and have had IBS-C for about 2 years following a bad case of malaria when I was working in Africa. I have been struggling to get help from my GI as I travel a lot, and so have not had a lactose intolerance test. I do, however, suspect that I am not lactose intolerant as I often have things like icecream and yoghurt and don't have D, although I do sometimes have cramping and bloating after icecream. Then again I seem to have bloating all the time. I am really quite slim, 5'7 and 8 1/2 st and look about 7 months pregnant. I need to take laxatives most of the time. My main problems are bloating and constipation. Recently I had to go to the ER as I hadn't been for over 3 weeks and my regular doctor wouldn't help me. I felt like I was going to pop 

Anyway, I have been looking into things some more and have decided to try going fructose free and try the FODMAP diet. I am confused though about wheat and dairy. Perhaps you can answer my questions?

- I have had a celiac test and it came back negative. Does this mean that I can have wheat on the FODMAP diet?
- if I am not lactose intolerant (I am trying to get the test done), can I eat dairy? I only really have yoghurt (plain) and icecream. At the moment I am just having a bit of yoghurt and no icecream. I miss icecream so much









Also are you aware if they are able to test for fructose intolerance on the NHS?

I am also really struggling with packed lunches as I usually have things like bagels and sandwiches. I do love tortillas but cannot find a plain corn one anywhere. There are 'corn' tortillas but they all have wheat flour in! Does anyone know where I can find these for a reasonable price?

Thanks so much
Emma


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## Shaylu (Feb 12, 2013)

Check this out for corn tortillas: http://www.mexgrocer.co.uk/gluten-free-tortillas.html

If you find that FODMAPS works for you then it could mean that wheat ( which is a FODMAP) is on your 'no' list.

I too am very slim and have always been unable to put on weight. In fact since being on FODMAP I have noticed if I eat one of the no foods than I loose more weight! It's almost like I have not eaten anything for the days that the stuff seems to stay in my system.

Also found that I cannot eat ANY type of sugar: refined, honey, fruit juices.

If I were you I would stay off the ice cream and yoghurts as they are high in lactose. Try almond milk. Also I have been told that Brie is low lactose so I can include that in my diet to ensure I get some dairy.

Remember that ice cream is full of sugar so you could be giving your system a double whammy!

The main thin I would say is that if you are still in pain than you need to change what you are putting into your body. So start the FODMAP diet and stick to it strictly and keep a food and symptom diary. When or if you notice any symptoms than your diary should flag up what caused it so you can then work towards cutting it out of your diet.

Google for recipes on wheat free, FODMAP friendly foods.

Cutting out sugar may seem daunting but give it a couple of weeks and your taste buds will adjust. The human body does not need sugar for any purpose. It is addictive and kills the body and mind!

Hope that helps


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## Shaylu (Feb 12, 2013)

Also add linseeds to your diet everyday. Grind them up before eating or adding to soups, drinks etc. I add a tablespoon to warm almond milk with fresh ginger everyday. This will help with your constipation and ginger helps with digestion too. Hopefully you will be able to stop taking laxatives. ( laxatives will make your bowels 'addicted' and lazy so eventually you will loose control of your bowels if you take laxatives regularly)


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## Kathleen M. (Nov 16, 1999)

Low FODMAP diet removes all fo the fermentable carbs, not just fructose.

Wheat has a large amount of fermentable carbs so may be a problem for some people even if the gluten (protein) is fine for them. They are two separate issues.

I would start the full low fodmap without the dairy and then see if you react when you add it back or not. Some peopel may tolerate some amount of fodmaps, but it helps to do the full elimination first to see if really helps you, then experiment with how much lee-way you have.


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## oscillate.wildly (May 19, 2013)

Thanks for the advice. I am still a bit confused about gluten free as it sounds like this is not ok, but when I look at the several lists of foods that I have found online they say that gluten free is ok.

I am also finding some conflicting things and I don't know whether the following are ok or not:

- soy milk (and soy icecream providing non of the added sugars etc)

- tomatoes

- courgette/zucchini

It feels so incredibly daunting and impossible. I don't know where to start


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## Kathleen M. (Nov 16, 1999)

If you are just trying to avoid gluten, the gluten free foods should be OK (so if you have celiac disease).

If you are trying to avoid FODMAPS gluten free foods (especially processed foods) may or may not be OK. It depends on which flours they use, what gums and other various assorted stuff they use to replicate the texture of gluten. Some are OK, some are not. So you have to read the label and know what all the stuff is.

People who need to avoid gluten because of celiac disease usually can eat all the fodmaps they want, so the flour and gums and various other food additives used in processed foods are only proven to be gluten free, not every other intolerance of every other disorder free.

Low FODMAP is pretty new so may take awhile before the food manufacturers decide it is trendy enough to market foods specifically designed for it.

Easier if you stick to whole foods rather than stuff that comes in a box, bag or can. Once the food manufacturers get to it you really have to be good at reading labels to figure out if it is OK or not.

Unfortunately that may mean you have to do more cooking from scratch, etc.

Soy, generally fermented soy is going to be lower in Fodmaps than soy milk. Rice milk or almond milk is probably a better bet.

Again. Soy milk is about peopel who are lactose intolerant. It isn't free of everything else that may be something someone else is intolerant of.

Foods are complex things. Pretty much everything has something in it people are intolerant of so if you try to avoid all intolerances in all foods you will have nothing else to eat. So they usually only try to limit one thing that may be a problem for one group of people rather than all things that could possibly bother anyone.

Summer squashes usually are OK (we have a good chart on the diet forum if you look that may be helpful).

Can't remember tomatoes off the top of my head. Some people have problems with some foods that have nothing to do with fodmaps so may include them in their list even when they are not on the official lists.


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## Shaylu (Feb 12, 2013)

oscillate.wildly said:


> Thanks for the advice. I am still a bit confused about gluten free as it sounds like this is not ok, but when I look at the several lists of foods that I have found online they say that gluten free is ok.
> 
> I am also finding some conflicting things and I don't know whether the following are ok or not:
> - soy milk (and soy icecream providing non of the added sugars etc)
> ...


Think of it as a learning curve. An experiment to find out suits you. Getting stressed and worried may make your symptoms worse so stay calm and happy. 
Have you got a basic FODMAP list? Start with that and within days I am sure you will notice improvements and / or will out find where to make further changes to your diet. Within the first week I found out I couldn't have any sugars or honey etc, also that tomatoes in excess (pasta sauces or over indulgence over a week) give me joint pain. I now have tiny plum tomatoes now and again without problems. Sugar is still an issue so may have to stay off that longer term.

Start the diet and if you have any questions or problems post back up here and someone will help you out.


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## Shaylu (Feb 12, 2013)

Post up here what you normally eat for breakfast, lunch and dinner, I am sure a few of us can offer you some advice on FODMAP alternatives to get you started.


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## LivingHappyWithIBS (May 22, 2013)

Like Kathleen said, "Low FODMAP diet removes all fo the fermentable carbs, not just fructose." So if you're truly trying to follow the low FODMAP diet, wheat and lactose (not all dairy) are out.

Luckily, there's some great wheat and lactose free products on the market. I used Udi's white bread a lot for sandwichs and toast in the morning. The best milk replacement is rice milk in my opinion. I compiled a list of low FODMAP sample meals and information to get started because I had a lot of people asking what I eat on a daily basis. I hope this gives you a little insight and help to understand your issues.

Also, I noticed that you said you are prgneant (congrats!). I just read a study that more than 70% of pregnant women stuggle with bowel issues, which may be contributing to your issues.


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## oscillate.wildly (May 19, 2013)

Thanks again everyone. It's nice to be able to get some answers!

I have such a small amount of soy milk so I wonder if it would be ok (just a drop in one decaff coffee and a little on porridge made with water) but perhaps a good idea to get rid of it and find some rice milk. It seems so expensive to do this diet....

Some help for food would be great. I mainly cook from scratch anyway so that is a start 

This is what I normally eat:

Breakfast: I have porridge each day made with water and 1/2 to 2/3 teaspoon of golden syrup. I usually put a bit of milk on the top, maybe able 1 or 2 tablespoons or so, so switched to soy milk so far for this.

Lunch: I am fine if I am at home but the problem is that I normally take a packed lunch into work each day. This was normally something like a bagel or sandwich or tortilla wrap, then some fruit (banana or the bad fruit!) and a yogurt. I would normally also have things like omelette with toast and lots of vegetables and a salad. I eat a lot of vegetables normally with lunch and dinner, and now I feel very much like I am not getting enough. I have switched to spinach (frozen), carrots and courgette. I am not sure if raw carrots cause problems but I like those a lot.

Dinner: now I am eating mainly chicken or fish with rice or potatoes, maybe a little bit of tinned tomatoes for a sauce, and some spinach carrot and courgette. I don't really know what else I can have. Maybe green beans?

I normally eat a lot of lentils, kidney beans, tinned tomatoes, of course lots of veggies especially green veggies and onions and mushrooms (oh I want mushrooms!), yogurt, tortilla wraps, Quorn and sometimes pasta. I never eat cheese so I am worried about calcium and vitamins and also fiber.

I am also not sure about coffee. I normally have one brewed coffee a day in the morning and I have now stopped this. I know this is a bit soft but I really do miss it and would certainly have it if ok, but I am not sure if for IBS you can't have any at all or if 1 cup is ok.

I generally just feel bad all the time and so far have not noticed anything, although it's only been a few days. One big problem is that I used to have an eating disorder. Although I am very much over it, my diet is restricted as a result and making food into so much of a focus again is hard. I am also about to start a course of Accutane (a very strong drug for severe acne), I am away from my partner for 4 months and I have just got back to the office to start writing up my PhD. It all feels a bit too much to deal with and this on top is a big stress, but I am so tired of feeling ill. I have NO energy and finding it hard to just get on with life at the moment.

Oh dear this has turned into a rant. Sorry about that. I guess one huge help would be ideas for a packed lunch that aren't going to break the bank. I don't know why I am drawing such a blank.

Thanks again everyone


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## oscillate.wildly (May 19, 2013)

LivingHappyWithIBS said:


> Like Kathleen said, "Low FODMAP diet removes all fo the fermentable carbs, not just fructose." So if you're truly trying to follow the low FODMAP diet, wheat and lactose (not all dairy) are out.
> 
> Luckily, there's some great wheat and lactose free products on the market. I used Udi's white bread a lot for sandwichs and toast in the morning. The best milk replacement is rice milk in my opinion. I compiled a list of low FODMAP sample meals and information to get started because I had a lot of people asking what I eat on a daily basis. I hope this gives you a little insight and help to understand your issues.
> 
> Also, I noticed that you said you are prgneant (congrats!). I just read a study that more than 70% of pregnant women stuggle with bowel issues, which may be contributing to your issues.


Thanks for the advice  that helps a lot

Ha I'm not pregnant though!


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## LivingHappyWithIBS (May 22, 2013)

oscillate.wildly said:


> Thanks for the advice
> 
> 
> 
> ...


LOL... Not sure where I got that.. oops! Can it be Friday already??


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## oscillate.wildly (May 19, 2013)

Sorry for more questions....

I am thinking about making soups for lunch. Would stock cubes be ok, or is even a very small amount of garlic and onion bad? Also, does anyone know about pearl barley? If I were to make something like carrot soup, would that be too many carrots in one go?

Sorry to ask so many questions but it is hard to get sound answers online purely because of the wealth of information, if you know what I mean!

Thanks


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## LivingHappyWithIBS (May 22, 2013)

I found this no onion, no garlic chicken broth: Progresso Tuscany Chicken Broth which I haven't found in stores yet, but I have ordered it online.

I also found that some bouillon cubes don't have onion/garlic either.


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## Shaylu (Feb 12, 2013)

Hi oscillate, wow looking at your list of foods, the only one area that looks okay is dinner of chicken, potatoes, rice. I would not add green beans just yet as they are on the no list. You can have the green part of spring onions and the green part of leeks ( only use these to make homemade stock).

I am afraid your morning coffee is a no no. Even the decaf stuff still has traces of caffeine and as I have found still gives me pain. ( having a couple of those days now as I had craving for earl grey tea and it was decaf!)

Golden syrup I am afraid could be a problem. Even FODMAP says you can have that I found my morning porridge was still giving me pains and narrowed it down to honey, syrups and refined sugar. I now flavour it with fresh ginger and cinnamon ( both good for digestion)

Lentils, beans etc are a big no. Last year I was advised to eat lots of lentils to increase my energy...only it made things 100 times worse. Protein wise try a little tofu.

Breads, wraps etc I am sure you know are out. Warburton a have just started doing on GF wrap that seems FODMAP friendly ( though not purse friendly at £3.00 for 3 wraps)

Soya beans are on the no list so I would think soya milk too. Try almond or rice milk. I think almond milk tastes much nicer anyway.

Oh have you started the Accutane?. I hope not. I found the FODMAP diet sorted my skin out. A lot of the time the breakouts are because of poor digestion ( not that a Dr would tell you this as they are not trained in this)

To make sure enough stay 'regular' add 1-2 tbsn of ground flaxseed(linseed) to your oats or just to a glass of warm almond milk with ginger and cinnamon.

Try Nairns gluten free oatcakes and Brie ( low in lactose) as snacks.

Bananas are a no and they slow down digestion. If you must have banana have it later in the day.

Also try to have fruit on its own and nothing else with it. This way it digests better.

Keep a food diary and note any symptoms down on it too.

Hope that helps


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## oscillate.wildly (May 19, 2013)

Thanks everyone for the help.

I am a bit confused now about green beans and bananas. They seem to be on most lists of OK foods. I am worrying about getting enough nutrition from fruits and vegetables.

I will swap to the almond milk. It is difficult because money is tight and so I am finding it hard to find alternatives that are not much more expensive than what I would normally buy. But I guess it's worth it!

My list of foods was mainly talking about what I would normally eat if I was not trying FODMAPs. At the moment it's all porridge, cornflakes, omelettes and potatoes, rice (white and brown), fish, tinned tomatoes (no more than 1/3 can per day), green beans, zucchini/courgette, red and yellow peppers, a few squares of chocolate a day, grapefruit, banana, mandarins. I was also having some yogurt and soy milk but I will stop those, and try to find an alternative for my porridge.

I have a few more questions if that's ok:

- what about very small amounts of milk powder? For example, 1 tea spoon of options hot chocolate I only use 1 tsp, not the recommended 3). It is such a teeny amount - is that still out of the question? Here are the ingredients: http://www.tesco.com/groceries/Product/Details/?id=267685528

I would think that the amount of milk powder in 1 tea spoon of the hot chocolate would be tiny.

- what about soy sauce?

- popcorn (made at home with just salt)

Sorry to pick on tiny things, I am sure you are all thinking 'just don't have it!' but I am struggling to find things to eat and some things are so stuck in my routine it would be great if I could keep some.

I am not sure about the accutane but my skin problems are really quite bad. I have cystic acne that is scarring and very painful. I am almost certain it is due to a hormone inbalance and stress, so I am quite desperate for a solution.

Thanks again 

Emma


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## Kathleen M. (Nov 16, 1999)

I can usually get almond milk for about the cost of soy milk, and you can make your own almond milk for cheaper at home if you have a good blender and a bit of cheese cloth.

Generally 1 cup raw almonds soaked overnight in water. Then drain the water off, put in a blender with 4 cups of water and let it blend until frothy and white. Strain the pulp from the milk and you can add whatever sweetener and flavoring you want.

You can use the pulp in baking or stir into cereals, etc.

As I said in the other thread. If you are doing an elimination to see if the diet can work at all you want to eliminate ALL fodmaps for a couple of weeks. If you already know the diet works then it is a matter of seeing what your tolerance level is. Usually people tolerate some.

If you cannot possibly live without the milk buy some lactase tablets (they are fairly cheap) and you can take them when you absolutely have to have your milk powder (if it causes symptoms compared to days you don't eat any fodmaps) as it will digest the lactose before it gets to your colon.


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## oscillate.wildly (May 19, 2013)

Thanks Kathleen.

I have a question about spelt. This looks great for bread and I would like to try, although it has gluten. Am I right thinking that this is fine for fodmaps because it's not gluten that is the problem? I tested negative for celiac. If I could use this for tortillas, bread and chapattis this would be so wonderful!


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## Kathleen M. (Nov 16, 1999)

http://www.med.monash.edu/cecs/gastro/fodmap/low-high.html

Which is one of the good sources for information seems to have splet as OK, so you could try it and see how you tolerate it.


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## Shaylu (Feb 12, 2013)

Hi again,
Chocolate is a no no:-(. If you can stick to no chocolate or sweeteners for two weeks than cravings will reduce too.
I was a real chocoholic and can go without now.

Milk powder? You really should not.

Soya sauce? No. But you can find Tamari which is usually gluten free and just like soya sauce.

If you can stay on the FODMAP diet strictly but still notice symptoms then swap some of the foods you're having of another on the FODMAP list. For example cut out the citrus fruits and try strawberry or blueberry ( in season now so make the most of them as they should be).

When you start 'wanting' or 'craving' anything on the no list remind yourself of how bad (pains etc) you will feel if you have it. And then remind yourself of how good you will feel eating the alternative

Enjoy the diet.


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## Shaylu (Feb 12, 2013)

Btw hot chocolate would have to go on the no list. Watch out for sugars. Even though FODMAP lists say some sweeteners are okay I found them one of the worst. ( my large jar of cadburys hot choc sits untouched in the kitchen:-( )

Oh and when you say 'tiny' amount. Remember it takes a tiny amount to trigger symptoms.
Sorry it sounds negative, but if the diet works for you will will look back and wonder why you didn't start it earlier


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## oscillate.wildly (May 19, 2013)

Hi Shaylu,

Thanks for the info. Please can you explain why chocolate is not allowed - I have found lots of lists saying that it is ok. For hot chocolate I am just going to have plain coca powder.

Also why would only gluten free soy sauce be ok? I thought gluten was ok (test for celiac is negative)

Thanks

Emma


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## Kathleen M. (Nov 16, 1999)

I think the plain cocoa powder may be OK but most chocolate has sweeteners or milk in it so that wouldn't be.

With fodmaps it is not an allergic or immune response so most people aren't super reactive to tiny amounts like someone with a peanut allergy or celiac disease will be.

But with fodmaps each tiny amount adds up. That is why if you really want to do the diet you generally do a severe form at first to make sure it works for you then and only tnen add back. Rather than trying to hit the amount you can tolerate by slowly pulling out one thing at a time.

Is it really totally impossible for you to give up the hot chocolate for 2 weeks to really see how much effect the full diet has?

Once you know what the full effect is then you can titrate back in fodmaps. It may be the full diet will control for you 75% of the symptoms. so you know when you add stuff back in the BEST you can expect is 75% better. If you go from the just take a little bit out, then take out a little bit more, you may decide it doesn't really work that well for you when you get to 40% better but you haven't really set the end points so you can't really judge because you never did completely free.

I think the problem with soy sauce is most of it has wheat in it. (there are a few brands that do not) If it has wheat in it , it has fodmaps in it. It isn't the gluten in the soy sauce you avoid if you are avoiding fodmaps, but they don't just add the gluten, they add the whole wheat so all the fodmaps go in as well.

There are a few things that are just the gluten from wheat, but most of the time, if it has gluten from the wheat, it also has the fodmaps.

You can't just add the fodmaps from wheat and have something be gluten free enough to get the gluten free label. If it is gluten free you know there is no wheat at all so no fodmaps from wheat.


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## Shaylu (Feb 12, 2013)

Hi Emma
Sorry for the late reply...but thanks to Kathleen for answering.

Go on ditch the chocolate and think abut the positives you could be gaining health wise


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## Roasted Rachel (May 28, 2013)

Bananas are a no and they slow down digestion. If you must have banana have it later in the day.

Every low FODMAPs list I have seen says banana's are ok. ???


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## Kathleen M. (Nov 16, 1999)

Fodmaps are not necessarily the one and only thing in a food that effects the system.

Bananas are often recommended when you have diarrhea from a disease because they are low in fodmaps which often tend to make diarrhea worse when you recovering from an acute GI illness.

I don't know if there is anything in them that deliberately slows the gut, but they lack many of the things that other fruits have (like sorbitol) that increase diarrhea in healthy people who have an acute GI illness. Most of those same compounds bother IBSers because they either add water to the stool or increase gas.


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## oscillate.wildly (May 19, 2013)

Hi everyone,

Thanks for the help and sorry for a late reply. I am being really strict and I think things are getting better. I still have bloating though. I think this is from constipation. Last night I took some duculax and have ended up with bad pain this morning. I really struggle with this. I am on Movicol but I try to not take it because I feel that it just makes me more bloated. If anyone has taken this please share your experiences!

I also got some 100% wholemeal spelt flour and I am very excited about making some bread! I will try a small bit and see how it goes.

Emma


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