The SciShow team has several “hot girls with stomach issues.” And they’re in doctors’  offices and on the internet like the rest of us trying  to solve those problems.

One solution that keeps coming  up is the low-FODMAP diet. Apparently you can’t have  yogurt, apple juice, mushrooms, and split peas, among other things.

Which sounds like the most  random assortment of food and drink possible. I challenge you to come up with  a more disjointed list of foods. And here’s where a lot of us run into a roadblock: to follow a low-FODMAP diet, you have  to know what the heck a FODMAP is!

So this video lays it all on the kitchen table. [Intro music] I don’t know how old you are, but most likely, when you were born, there was no such thing as a FODMAP. Well, high FODMAP foods existed, but nobody called them that. Back then, if you had irritable  bowel syndrome, or IBS, you might avoid foods like  cabbage, beans, and onions.

You know, gassy foods. But it wasn’t until 2005 that two doctors in the Department of Gastroenterology  of a hospital in Australia gave those foods a name: high FODMAP. It’s an acronym for Fermentable oligosaccharides,  disaccharides, monosaccharides, and polyols.

You may still be wondering  what the heck a FODMAP is. But the acronym can be broken down  to become a bit more digestible. A lot of it describes sugars.

Certain fruits and vegetables are chock full of simple  sugars called monosaccharides, like fructose. . . . These monosaccharides can also bond  together to make more complex sugars. A pair of them is called a disaccharide, like lactose found in dairy products. .

And up to 10 sugars linked  together is an oligosaccharide. That’s the kind of complex carbohydrate  you’re probably familiar with from wheat grains and beans. . So all of those foods are high FODMAP.

Plus sugar alcohols, or polyols, which are broken down sugar byproducts. These are commonly used as artificial sweeteners because their structure can make  them hard for your body to digest, creating a lower calorie effect. . These molecules are all fermentable, which means the bacteria in your  gut can quickly break them down, often into a gas.

The gas released from fermentation can make you… well, gassy… which is why your stomach sometimes  feels like an overfilled balloon when you eat high FODMAP foods. But if you’re sensitive to FODMAPs, you can also end up with more severe symptoms, like diarrhea. That side effect comes from how hard  it is to get FODMAPs through your body.

Most nutrients get absorbed  in the small intestine, but FODMAPs don’t absorb well. That’s because they’re too big to  slip through the intestinal lining. Which means a lot of them go on  to get fermented in your colon.

The imbalance of molecules  creates osmotic pressure, where water gets pulled into your gut. And then you have a lot of liquid  in your gut that makes its way out in the form of runny poop. This might sound all too familiar if you have the chronic inflammatory GI disorder, Crohn’s disease.

One of the hallmarks of Crohn’s  is something called “leaky gut.” It’s an imbalance of nutrients and  water being absorbed in your intestines that the Australian doctors hypothesized was related to fermenting FODMAPs. So you might try and adjust your diet to  prevent this from happening all the time. Maybe instead of wheat-based bread or pasta, you stick with rice or go  with gluten-free options.

Swap out onions for chives in your salads. Snack on some carrots rather than cauliflower. Eat more eggs and fish for  protein and avoid beans.

Basically, you’re experimenting  with a low-FODMAP diet. You can cut out high-FODMAP  foods from your diet entirely, which might be worth it if you're constantly  dealing with severe Crohn's symptoms. But for people who aren’t  diagnosed with Crohn’s disease, and instead have some other  form of IBS or GI issue, the low-FODMAP orange juice  might not be worth the squeeze.

Especially because completely eliminating  large portions of major food groups can cause other problems. Such a strict diet could  result in poorer nutrition, an imbalance of the bacteria  that lives in your gut, or the potential to trigger eating disorders. And that’s just when it’s possible to  limit yourself to only certain foods, which is not an option for everyone.

So the low-FODMAP diet has evolved  since it was first served up. Instead of completely eliminating  a whole bunch of foods, it’s now a phased approach to  discover your personal trigger foods to avoid for the long term. But before we get to that,  all science needs funding.

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With the guidance of a doctor or nutritionist, you go through three phases: Phase One — restrict food  to only low-FODMAP foods. This is essentially the elimination. It won’t be fun to go on such a  strict diet for four-to-six weeks, but it might just be worth it to  determine if you are sensitive to FODMAPs.

If you find that your symptoms improve, then you move onto Phase Two — systematically reintroducing  different types of high FODMAP foods. Basically, you’re testing which  foods are full of the FODMAPs that cause you to get those rumbly tummy symptoms. Still not fun, since you’re essentially  trying to give yourself symptoms.

In this phase, you’re playing toilet  roulette with high-FODMAP foods until you make it to Phase Three, where you get to personalize your diet. Now that you know which  FODMAP foods you can tolerate and which you can’t, you can avoid the trigger foods and  are free to eat everything else again. The goal is to get you to a place where  you feel comfortable managing it f or the long haul.

That whole process is, I’ll just say it, a pain in the butt. So the future of low-FODMAP diets  might include a few bonus phases, making it a five-phase approach that  actually might simplify the whole thing. Before the elimination phase, experts propose a Phase

Zero: poop screening. They’ll run tests on your stool sample that can predict if you’re likely  to respond at all to this diet. …Because you don’t want to go through the gauntlet if FODMAPs aren’t really your issue. And if they are, then you’d run through the three phases and maybe even end on a fourth phase that would help your gut adapt so that  you don’t have to be super restricted for the rest of your life. Here, I’m talking about treatments  like targeted enzyme therapies.

Right now researchers are still  ironing out phases and treatments, but some of them are pretty exciting! So we’re quickly moving  into the future of FODMAPs. But since we’re not there yet, s ome people still need a less aggressive approach than the three-phase gauntlet.

You might not be able to stick  to a restrictive low-FODMAP diet because you’re a young kid  who won’t eat much of anything or you’re underweight or pregnant. In those cases, you might be tempted by the newer  “FODMAP-gentle” or “FODMAP-light” approach, which is a bit less strict. The idea is to only restrict a few  very high FODMAP foods at first and expand your restrictions if needed.

The pros to this gentle approach are  that you can get more food in you. The cons are that we don’t  really know if that food is going to keep causing the same problems you started off with. Right now, data is mixed  as to whether this approach actually does much for you.

So if you can, the full on  version is still gold standard. While we’re still working out a less  restrictive low-FODMAP approach, we have made tons of progress  since FODMAPs were first … very badly… named. Today, there are even tests  that can help diagnose you and to quantify how your symptoms  change after starting a low-FODMAP diet.

Like, they can measure the  amount of hydrogen in your breath to see how much fermenting your  large intestine has been up to after you’ve eaten a high-FODMAP trigger food. And professionals might be able  to see how sensitive you are to certain FODMAPs using MRIs to  measure the water and gas in your gut. So we’re making the low-FODMAP  life more personalized to exactly what’s bothering your bowels.

And we’re learning that it  goes beyond Crohn’s and IBS. The diet might help symptoms with gluten-related disorders,  abdominal pain disorders, and even endometriosis! In one study, 60% of endometriosis patients had less abdominal pain and bloating after changing to a low-FODMAP diet.

Another clinical trial  suggested that a low-FODMAP diet might even keep babies from crying! Not that they were feeding  babies the low-FODMAP foods — but when breastfeeding  parents ate low-FODMAP foods, they said their babies with colic were less fussy. In just the few decades that it’s been around, research suggests the low-FODMAP  diet is a successful treatment option for all sorts of issues.

You might not have to spend  your whole life putting up with those crappy symptoms after all. But you will spend your  time explaining what FODMAPs are to everyone who hasn’t seen this video. [ outro ]