Road to RDville: PCOS and FODMAPs 2

Happy Monday! I thought about calling this post “Road to RDville: All About Acronyms.” I’m sure you can see why.
In my ambulatory (outpatient) rotation this week, I helped counsel a new patient who was recently diagnosed with PCOS after she was having trouble getting pregnant. It was a great opportunity, because I wrote two patient education brochures on PCOS for University of Washington Medical Center last year as a public health fieldwork project. One was on the ins and outs of PCOS, in easy-to-understand terms, and the other was specifically on how nutrition, physical activity and weight control can improve PCOS and prevent complications like type 2 diabetes, infertility and heart disease.
FODMAPs refers to fermentable monosaccharides, disaccharides, oligosacharides and polyols. They are specific types of sugars and fiber that may be responsible for symptoms if irritable bowel syndrome (IBS) in about 75 percent of IBS patients. Last week, for one of my internship assignments, I put myself on a FODMAP elimination diet for several days. When an actual IBS patient does a FODMAP elimination diet, they go on it for two weeks (although they often start experiencing symptom relief in a few days). Then they “challenge” each of the FODMAP categories to find out which foods are problematic, and in what amounts. The ultimate goal is to be able to avoid symptoms while enjoying as varied a diet as possible.
Trying out this diet was a valuable experience, because when you actually do something instead of just reading about it, you more easily spot any pitfalls or areas of confusion. I personally had a hard time following the diet because, other than the learning experience, I saw no payoff. I don’t have IBS, so I only felt deprived! The foods I missed the most were Brussels sprouts, lentils, apples and onions/garlic. Seriously…do you know how many foods and condiments have onions or garlic?
Now, if I had IBS, and was suffering from gas, bloating, diarrhea and constipation on a regular basis, to the point where it was affecting my day-to-day life and making me dread traveling on an airplane or any interstate with minimal rest stops, I would be thrilled to go without certain foods for a few weeks to figure out  what’s causing the problems.
I’ll write a bit more about IBS and FODMAPs later this week.