Constipation & FODMAP connection

Could high FODMAP food be at the root of your constipation woes?

Is your constipation worsening after bariatric surgery despite increasing your fiber intake? Do you know why this is happening?

In this episode, we explore how FODMAPs contribute to post surgery constipation.

What are FODMAPs and how do they contribute to constipation? Want to know? Now let’s examine fiber, its types, FODMAP and the link between constipation and FODMAPs.

First, When fiber doesn’t help constipation?

Fiber in the diet increases stool weight and size as well as softens it. You are less likely to experience constipation when you have a bulky stool.

If you experience bloating and blockage after adding fiber to your diet, there are several possible reasons. For instance, a condition called “slow transit constipation,” which is a slow movement in the bowel, causes fiber to sit in your gut and worsen your symptoms.

Second, Where do fibers come from?

Dietary fibers are typically composed of long, repeating chains of sugar derived from indigestible parts of plants. Most fiber is obtained from cereal husks and grains, which contain cellulose and lignin, two insoluble fibers. Fibers are primarily complex type of carbohydrates.

 Third, 3 Types of fiber

Technically there are 3 types of fiber:

1. Soluble 
2. Insoluble
3. Resistant starch

Soluble fiber

Soluble fiber can dissolve in water to form gels.  You find this type of fiber in plant cells.  Soluble fiber is fermented by gut bacteria in the colon. Producing short-chain fatty acids(SCFA) and gasses. 

Soluble fiber draws water into your gut, which softens your stools and supports regular bowel movements. It not only helps you feel fuller and reduces constipation but may also lower your cholesterol and blood sugar levels.

Soluble fiber is found in beans, oats, fruits and veggies. 

Insoluble fiber

This fiber makes up the structural part of plant cell walls.  It adds bulk to the stool and appears to help food pass more quickly through the stomach and intestines.

You can find insoluble fiber in the skins of fruits and vegetables, nuts, seeds and whole grains.

Resistant starch

Resistant starch isn’t typically thought of as a “fiber”, but it resists normal digestion in the small intestines.  Acting similarly to soluble fiber with producing SCFA. It helps feed the friendly bacteria in your gut and increases the production of short-chain fatty acids such as butyrate.

Fourth, How we digest carbohydrates

During digestion, carbs undergo both mechanical (chewing) and chemical breakdown (in the small intestine).

If you eat fiber, starches, sugar, or whatever type of carbohydrates. It goes to the colon. As these sugars, starches, and fibers go into the colon, the gut bacteria begin to ferment them. And then it produces a number of substances including short chain fatty acids, which are great.  But it also will produce gas like methane and hydrogen. 

Fifth, It’s all about the fermentation!

During the fermentation of carbohydrates, gut bacteria produce energy. During fermentation, a single carbohydrate (glucose, lactose, sucrose, etc.) is added to the base medium to provide nutrients for the bacteria. 

When the gut microbiota is unbalanced, as is the case with SIBO, constipation occurs.

There is a significant difference in gut bacteria composition between individuals with constipation and non-constipated healthy people, with methane-producing bacteria in their intestines slowing intestinal transit times.

Sixth, How fermentation impacts constipation?

Carbohydrates, fibers and sugars ferment differently. So it’s really all about the fermentation that’s happening. And if you have an increase in fermentation in your colon, this is going to affect transit time. So that is the motility that your colon, the peristalsis, that muscular movement that occurs for your whole digestive tract really has this peristaltic motion that allows food to pass and move through your whole digestive tract. But that’s how we have bowel movements. And that’s how we move food and stool out is through that, that motility, that transit time. So if you have slow motility, you’re going to have constipation. If you have a fast, you’re going to have diarrhea.

When this fermentation is happening, you are also getting an increase in gas, increase in fluid, cause that is the colon’s job to draw in fluid and the gut bacteria to start fermenting and they produce the gas. 

So, when that happens, your bowel gets distended. If you have digestive issues, you may also experience bloating and abdominal pain.  People who don’t have digestive issues, they don’t notice issues with consuming fiber.   

When you have that distention in your bowel, it affects how the muscles of the bowel wall contract, and then that’s when it impacts your motility. And that’s why you can be constipated. So if you are struggling with constipation getting to that, the right fiber in the right dose is the key point. So, this is where we dig into FODMAPs. 

Seventh, What are FODMAPS?

FODMAPS is the acronym for:

F=fermentable

O=oligosaccharides

D=disaccharides

M=monosaccharides

A=and

P=polyols

These are short-chain carbohydrates/sugars/fibers that can be poorly absorbed in the small intestine and fermented by bacteria in the colon.  

Some studies support the effectiveness of a low FODMAP diet in treating functional gastrointestinal symptoms.

A 2014 study in Gastroenterology found that reducing dietary FODMAPs, which restrict certain short-chain sugars and fibers, improved symptoms in IBS patients, including those with both diarrhea and constipation.

Some other studies have shown that low FODMAP diets may alleviate constipation-related pain and bloating.

A 2019 study found that FODMAP-rich foods increase symptoms of IBS and worsen them.

Hence, low FODMAP diet improved bowel movements in patients due to the fermentation issue. But FODMAP-rich foods also have their advantages. Thus, if you are experiencing constipation, working with a Registered Dietitian who understands FODMAPs is the best way to resolve it. 

Finally, do you experience constipation?

Is your constipation chronic after bariatric surgery? Understanding the root cause is important, but providing relief until you discover it is key! 

Working with a Registered Dietitian trained in FODMAPS like myself, can work with you to remove & reintroduce foods at the right time and at the right dosage to improve your motility.

Here’s to a great start! Take a look at my packages and contact me for a free consultation.

It won’t disappoint you…

Your future health awaits…