Rice Milk Gets the Low-FODMAP Green Light from Monash!

rice milk low fodmapThere’s been a lot of back and forth about rice milk and whether or not it’s low or high in FODMAPs. Monash University had warned us in August of 2015 and in earlier reports that rice milk had an overall rating of HIGH when consumed at a 1/4 or 1/2 cup. I am happy to share with you that rice milk has definitely received the green light to be low in FODMAPs.

Stick to a low-FODMAP serving of 200ml, otherwise high quantities could mean high amounts of the FODMAP fructans (the “O” in FODMAP, Oligosaccharides)

doctor jane muir monash universityDr. Jane Muir, Head of Translational Nutrition Science in the Department of Gastroenterology, Central Clinical School, Monash University and her team have conducted some further testing and analyzing and reported on Sunday that rice milk is LOW in FODMAPs. That’s great news for vegans, vegetarians and anyone that enjoys non-dairy milk.

Here’s a snippet from their blog post: “We have now reviewed the rating for rice milk and will be modifying this accordingly. We have given a safe (low level green rating) for 200 ml of rice milk per sitting. The results for the Australian, UK and US will be in the app very soon. We apologize for any confusion this may have caused – but this is science in action! and part of the ongoing research and refinement of the Monash University Low FODMAP diet. Be careful: There are still some fructans present in some rice milks and therefore we do not recommend very high quantities of rice milk in one sitting.” You can take a look at the full post here.

And since we are on the topic, here are other non-dairy milk options for you that are low in FODMAPs, with low-FODMAP servings:

  • Almond milk (1 cup)
  • Coconut milk, canned (1/2 cup)
  • Coconut (UHT-ultra high temperature) (1/2 cup) (150 ml, moderate in FODMAPs)
  • Oat milk (1/8 cup)
  • Hemp milk (1 cup)
  • Soy milk (soy protein 1 cup)
  • Soya milk unsweetened (hulled soya beans) (1/4 cup) (1/2 cup moderate in FODMAPs)*contains moderate amounts of Oligos-GOS. Limit intake

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Looking for help on the low-FODMAP diet?  Ask me about my nutritional coaching services by contacting me here.

Be good to yourself and your gut!BEC_6825

Colleen Francioli

Certified Nutritionist Consultant
Founder FODMAP Life & BonCalme
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Abundantly Happy Kale, Grains and Seeds Salad – New low-FODMAP Recipe!

Abundantly Happy Kale, Grains and Seeds Salad

I’ve been enjoying my time as a co-host for the #21dayfodmapchallenge, created by Julie of CalmBellyKitchen.com and also co-hosted by Anna of FODMAP Journey, who has guest blogged for FODMAPLife several times (check out this awesome post of Anna’s).

If you haven’t joined in yet there’s still time!  Learn more by visiting my Instagram profile here.

Yesterday’s theme for the#21dayfodmapchallenge was Great Grains so I decided to finish a recipe I’ve been working on, and I hope you enjoy it!

This salad is a low-FODMAP phytonutrient and vitamin powerhouse and it’s also colorful, crunchy and easy to make.  Vegetarians and vegans will love the mix of veggies, seeds, grains and nuts.  If you’re a meat-eater (and you just need to have your meat) you can always add a piece of grilled fish or lean meat to this salad, however I think it’s perfectly filling as is.  Make ahead of time and have for lunch the next day or bring to a gathering.

low fodmap grain salad
photo by: Colleen Francioli

Ingredients 

Serves 4

  • 9 leaves curly kale
  • 1/2 teaspoon sea salt
  • 3 tablespoons extra virgin olive oil, divided
  • juice of one lemon
  • 1 teaspoon turmeric
  • 1 teaspoon curry powder (purchase one without FODMAPs)
  • 1/2 tablespoon ginger, freshly grated
  • 1 celery stalk, diced
  • 1 yellow bell pepper, diced
  • 1 medium carrot, cut into matchsticks, then into thirds
  • 1 tablespoon pumpkin seeds
  • 2 radishes, sliced very thin
  • 1 cup brown rice, cooked
  • 1 cup quinoa, cooked
  • 1 cup buckwheat, cooked
  • 1 tablespoon slivered almonds

Directions

  1. Cut away ribs and stems from kale, wash thoroughly, drain in colander.  Chop kale leaves into long, thin shreds.  Add to a large-sized bowl and sprinkle salt and 2 tablespoons oil on top.  Massage leaves with hands until leaves begin to darken and soften.
  2. Add remaining oil to bowl, squeeze in lemon juice, discarding any pits. Add in turmeric, curry powder, ginger, celery, yellow bell pepper, carrot, pumpkin seeds, radishes, brown rice, quinoa and buckwheat.  Toss to combine.  Add more lemon juice or olive oil if desired.  Divide onto plates and top with slivered almonds.  Keep covered in refrigerator for up to three days.

*Tip – If brown rice, quinoa and buckwheat have been made ahead of time (a smart idea!) and are cold, I like to combine all into a skillet with 1 tablespoon unrefined coconut oil to warm up before adding to the other salad ingredients.  Preparing such low-FODMAP staples such as these ahead of time makes it much easier to follow the low-FODMAP diet. During your busy week, add them to salads, soups, stir-fry, sandwiches and more.

Hope you enjoy!  Don’t forget to follow me on social media and sign up for my newsletter! Follow/like/comment on FacebookInstagramTwitter and Pinterest.

Have a great rest of your day/evening, where ever in the world you are!

Colleen Francioli

Certified Nutritionist Consultant

 

Your Facebook Questions Answered, Q and A Sunday – Low-FODMAP Diet

This post is dedicated to our Facebook fans!  A couple weeks ago I asked on Facebook:

“Tell me one thing you’d like to learn more about (the low-FODMAP diet) and I’ll choose ten comments to respond to via a blog post.”  There was a huge response, and many of the ten questions I chose did not come with simple explanations (as you all know perfectly well, this is certainly not a simple diet!).  Also, everyday I receive dozens of questions about the diet via Facebook, Instagram, Twitter and email.  So I felt it was a great opportunity to do something different and bring you the Low-FODMAP Diet Q & A Sunday.

low fodmap q and aWhen ever you see the image above on my social media channels, just ask your question below the image and check my blog every Sunday to see if I’ve answered your question.  Take this opportunity to read other fans’ questions as you will learn much about the low-FODMAP diet!

So without further ado, here are two REALLY GOOD questions to which I’ve got great answers:

Question 1: Rachel Wittman Cox- Question: “What is a good filling easy fodmap breakfast and how long do most people stay on it before noticing improvements?”

Answer:  I tend to go with eggs whites in the morning for some nice filling protein.  I’ll then add a low-FODMAP cheese like mozzarella, a low-FODMAP veggie like spinach and a piece of gluten-free toast with coconut oil or butter.  Other ideas are:

  • Gluten-free oats with 1 tbsp slivered almonds and 10-20 blueberries
  • Quinoa flakes with almond milk, 3/4 cup strawberries and 10 macadamia nut halves or other low-FODMAP nut.
  • Lactose-free yogurt with 10 raspberries, 10 walnut halves and a sprinkle of unsweetened coconut flakes.
  • Gluten-free toast with 1 tablespoon sunflower, peanut or almond butter and two small, peeled kiwis.

To answer the other question, some people feel results in a couple days, some a couple of weeks.  Everyone is different, and it also depends how diligent you are about following the diet.  Thankfully up to 70% of people following the diet can find an improvement in symptoms (per research by Peter Gibson, a professor of gastroenterology at Australia’s Monash University, and co-founder of the low-FODMAP diet).

Gut health word cloud on a white background.

Question 2: Karen Hazlett – Question: “I know I can’t digest high fodmap foods but I have no idea why, medically speaking. Is there a known reason?”

Answer: Some people have trouble digesting FODMAPs due to the fact that FODMAPs ferment, causing gas/wind, bloating, diarrhea, distention and/or constipation. FODMAPs are short-chain carbohydrates which are poorly absorbed in the small intestine (your small intestine is supposed to absorb nutrients and minerals from food) and then are rapidly fermented by bacteria in the gut. The bacteria produces gas which plays a large role in the onslaught of symptoms.  The bacteria are basically eating FODMAP carbohydrates and then fermenting the sugar molecules.

Since fermentation causes gas it can make diarrhea worse or contribute to constipation. The methane gas that is produced can cause constipation while the hydrogen can increase GI motility.  What is GI motility?  It is defined by the movements of the digestive system, and the transit of the contents within it. When nerves or muscles in any portion of the digestive tract do not function with their normal strength and coordination, a person develops symptoms related to motility problems.

These FODMAPs or small undigested remnants of oligosaccharides, disaccharides, monosaccharides and polyols accumulate gases and cause what is called an osmotic effect.

FODMAPs are “osmotic” which means they cause water to be drawn into the intestines, leading to diarrhea.  Stool stays more watery than usual which leads to bloating, gas, diarrhea, and pain.

The food we eat is broken down by one or more enzymes which are chemicals that digest foods into energy for your cells.  In order for carbohydrate digestion to take place we need amylase.  Amylase is produced in the pancreas and the glands that make saliva.  As you chew, the amylase continues to break down carbohydrates throughout your digestive system. Amylase breaks down carbs into their individual sugars as they pass from the mouth to the stomach and the gut. The cells lining your gut can absorb them and distribute them to other parts of your body for energy.

Since FODMAPs aren’t completely digested in the small intestine like other carbs, they manage to pass through to the large intestine intact, instead of being absorbed in the gut and used for energy. Why does this happen?  It’s because we can’t break down FODMAPs (a) or we can’t absorb them in the small intestine (b):

(a) Amylase is the main enzyme responsible for starch digestion, and if the quantity of starch consumed is so high that not enough amylase is available to keep up with it, your gut may not digest everything. Some FODMAPs reach the large intestine intact because a person does not have the enzymes necessary to digest them. People who have lactose (the disaccharide “D”) intolerance have a deficiency of the enzyme lactase (needed to break down lactose down into simple sugars). Everyone reacts to raffinose (one of the oligosaccharides, the “O” in FODMAPs), because humans lack the enzyme to completely break it down.  Raffinose is a sugar present in sugar beet, cotton seed, and many grains. It is a trisaccharide containing glucose, galactose, and fructose units.

(b) Fructose (the monosaccharide “M” in FODMAPs) is a simple sugar and doesn’t need to be broken down further.  It is difficult to absorb, so it stays in the intestine instead of getting transported through the intestinal wall into the body.  So for instance, with fructose malabsorption there is an increased concentration of fructose in the entire intestine.  In order for fructose to be absorbed in healthy people, only about 25–50 g can be consumed per sitting. People with fructose malabsorption absorb less than 25 g per sitting.

Humans can produce small amounts of the enzymes needed to break up galacto-oligosaccharides and fructans into their individual subunits.  One person to the next may handle galacto-oligosaccharides and fructans differently.  As an example, you might be able to enjoy hummus and break down the galacto-oligosaccharides in it, but you may not be able to break down the fructans in the bread you used to dip in the hummus.  It might be the opposite for someone sitting next to you with IBS.  Our immune systems (for people with and people without IBS) handle food, outside pathogens and stress differently.  And to be very scientific:

Humans have a limited absorptive capacity for fructose since its absorption is an energy independent process and this capacity is quite variable [9, 10].

“Malabsorption of fructose generates an osmotic force which increases water influx into the lumen and then leads to rapid propulsion of bowel contents into the colon, which is then fermented and leads to production of gas.

Stomach / Guts / Small Intestine - Male anatomy of human organs - x-ray view

“The most common structural forms of fructan are inulin, levanare and geraminan. The human body has limited ability to break down these oligo- or polysaccharides in the small bowel and only absorbs 5 – 15% of fructan [22, 23]. The mechanism for malabsorption and intolerance is related to the lack of enzymes to fully hydrolyze glycosidic linkages in the complex polysaccharide, and therefore results in the malabsorbed fructans to be delivered to the colon, which are then fermented [24]. Furthermore, the small molecule of fructans draws more water into the intestine which can result in bloating and diarrhea [24].

“At least 70% of polyols are not absorbed in healthy individuals [29].

In our gastrointestinal tract, we have two primary types of bacteria called bacteroidetes and firmicutes. Bacteriodetes are good because they will eat carbs, protein and fat, but firmicutes eat mostly carbs and fiber. Research has found that people with IBS, (which is often a SIBO related condition) tend to have more firmicutes than bacteriodetes.  The more firmicutes one has in the gut, the more there is to ferment FODMAPS.  “Approximately 100 trillion bacterial cells live in the GI tract, mostly in the large intestine.  While colonic bacteria predominantly are from two bacterial phyla, Bacteroidetes and Firmicutes, there are about 400 species represented and the gut flora profile (type of bacteria and amounts of each type) is highly variable from one individual to another and even within individuals over time. Family members, however, share more similar gut flora than unrelated individuals.”

Then there is STRESS and did you know that stress can affect bacteria?  When you are going through a rough time like the death of a loved one, the loss of a job or the ending of a relationship, the emotional stress you experience releases adrenal stress hormones, like cortisol and adrenaline. Your brain gets worked over by these stress hormones as your vagus nerve gets stimulated. The brain-gut connection is this same vagus nerve that is involved with stress.  Your blood supply is reduced and therefore it’s harder for your body to properly digest foods and manage the balance of bacteria (a balance is essential for your gut-microbiome). Stress hurts your digestion, and poor digestion makes you feel more stressed.

And finally, please read this response from Jane G. Muir, PhD and Peter R. Gibson, MD in Gastroenterology and Hepatology July, 2013, The Low FODMAP Diet for Treatment of Irritable Bowel Syndrome and Other Gastrointestinal Disorders: “The topic of food intolerance is a challenging area of research, and more quality research is required. The success of the low FODMAP diet for control of gastrointestinal symptoms associated with IBS and the controversy surrounding gluten sensitivity have stimulated greater interest in dietary research. Besides carbohydrates, there are many other food components worthy of study. For example, dietary fat has been shown in acute studies to change visceral hypersensitivity. Naturally occurring chemicals are widespread in foods and can interact with receptors in the gut or have direct, possibly pharmacologic actions on the enteric nervous system and mast cells. Although dietary approaches that restrict natural salicylates, glutamates, and amines are currently in practice, few well-designed studies investigating the potential role of food chemicals in patients with functional gut disorders have been performed. Clearly, more work is required in this area.”

That’s it for this Sunday.  Don’t forget to follow me on social media an sign up for my newsletter!

Have a great rest of your day, and I look forward to your questions!

Colleen Francioli

Certified Nutritionist Consultant

Sources:

Low Fodmap Roasted Brussels Sprouts

brussels-sproutsA delicious recipe for this holiday season that you can share with the family.!

*Brussels Sprouts are a moderate fructan food so when serving this recipe with family and friends, make sure YOU only have a 1/4 C serving.  Do not have three or more whole sprouts.

Roasted Brussels Sprouts

Ingredients:

1 1/2 pounds Brussels Sprouts
1/2 TBS Garlic-infused oil
5-7 slices bacon, chopped
Sea Salt (or Himalayan Crystal Salt) & Pepper
Cayenne pepper (optional)

Directions:
Chop the brussels sprouts in half
Place chopped bacon in the frying pan and saute on medium heat
Add the garlic-infused oil and the brussels sprouts
Add a pinch of salt, and a pinch or two of pepper, as well as a pinch of cayenne pepper if you want a spicier dish
Continue cooking everything over medium heat until the brussels sprouts are cooked through. Enjoy!

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RD Tamara Duker Answers Questions about the Low Fodmap Diet

I recently had the pleasure of interviewing Tamara Duker, a Registered Dietitian (RD) with a master’s degree in Clinical Nutrition.  She knows a thing or two when it comes to food and nutrition, cooking and eating, recipes and healthy living. She is a cake lover challenged with gluten intolerance (like so many other ladies!).  Her practice is based in New York City and she has expertise in helping people with:

  • Soft diets for dysphagia
  • Gluten-free diets
  • Low-FODMAP diets for IBS and SIBO
  • Lactose-free or low-fructose diet for digestive intolerances
  • Medically-supervised elimination diets for Eosinophilic Esophagitis

Here is Part One of our interview – please read and then check back next week for Part Two:

tamara dukerCF – What would you say is the average age of people coming to see you for the first time?  Are they a mix of male and female or mostly female?  Do you find that they’ve come to see you because someone else has recommended they see an RD, or do you find you’re receiving more e-patients?

TD – While I see patients of all ages– from 11 at youngest to 80-somethings at the higher end, my “typical” patient is a woman in her 20s-40s.  Commonly she reports having had a “sensitive stomach” or “stomachaches” since childhood that has recently gotten worse, but in other cases I hear she was totally fine until one time she got sick when traveling, and then her bowels have never been the same since.  They come to see me out of desperation– either they find me via google (my name comes up a lot when you google “bloating” or FODMAP-related search terms, as I write extensively on these topics for US News), or their gastroenterologist referred them to me.

CF -What are the lactose-based products they are most unhappiest to part with?

TD – My lactose intolerant patients are unhappiest to part with pizza, ice cream and yogurt.  Often, they part with the yogurt and then suffer through the pizza and ice cream.  The problem with pizza/ice cream is that often its the high fat content that triggers IBS symptoms rather than the lactose per se–so even if they take a lactase supplement, they still may not tolerate these foods well.  They are beyond ecstatic to learn that there is a lactose-free, low fat  real dairy yogurt available, as soy yogurt tastes awful, coconut milk yogurt is a FODMAP bomb and almond milk yogurt is a sugary, carb bomb.  Healthy snacking is much more convenient when yogurt is an option.

CF – Can you please describe Medical Nutrition Therapy?

TD – Medical nutrition therapy is different from nutrition counseling or education in that diet is a prescription to treat or improve a medical condition.  Some examples of this would be: gluten-free diet for celiac disease, using soluble fiber therapy to improve IBS-D, using the low FODMAP diet to manage symptoms of chronic bloating in IBS, etc.  Medical nutrition therapy, importantly, is evidence-based and employed by credentialed clinicians, often in close collaboration with a medical doctor.

CF – Can you provide other tips for the lactose intolerant crowd/FODMAP fans?

TD –

  • Watch out for protein powders, drinks or bars that use whey protein concentrate or milk protein concentrate.  These can be very high in lactose.
  • If you use lactase supplements to help digest conventional dairy, use chewables, not tablets.  Chewables are much more effective.Take with the first bite.  Take additional dose mid-way through the meal/snack if there’s a lot of lactose.
  • Green Valley Lactose Free yogurts are the most FODMAP-friendly yogurts I have ever encountered.  If Green Valley Organics yogurt is not available in your market, look for Redwood Hill Farm goat’s milk yogurt instead– its about 40% lower in lactose than conventional yogurt, which is comparable to your typical Greek yogurt.  To reduce its lactose content even further, you can strain it for 2 hours in a paper-towel lined seive/strainer over a pot, which yields a thicker greek-style texture (lactose is water soluble, so it leaches out with the excess liquid).  I have a recipe for “Goat’s Milk Labne” here which I absolutely love.

If you have any comments, please share them below!  Thanks!  Check back next week for Part Two.

~ Colleen

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10 Facts About FODMAPs

fodmaps

In the 90’s, Dr. Sue Shepherd developed a form of fructose malabsorption diet. Subsequently a team at Monash University, led by Professor Peter Gibson and including Dr Shepherd and others, developed the low FODMAP diet.

Through their research, they found that limiting dietary FODMAPs can be an effective treatment for people with symptoms of IBS.   Other researchers and Registered Dietitians across the world have also been able to prove the effectiveness of this diet.  Aside from IBS (which I suffer from) there are other gastrointestinal, and inflammatory disorders and diseases that can also be treated naturally whilst sticking to a low-FODMAP diet.  The facts below are what I have learned from Dr. Shepherd, Monash University and several other FODMAPs experts.

1) FODMAPs are…

  • Fermentable – rapidly broken down by bacteria in the bowel
  • Oligosaccharides – fructans and galactooligosaccharides (GOS)
  • Disaccharides – lactose
  • Monosaccharides – fructose and…
  • Polyols – sorbitol, mannitol, maltitol, xylitol, polydextrose, and isomalt

stomach_pain_b&w2) FODMAPs are poorly absorbed in the small bowel.

3) Multiple types of FODMAPs are usually present in most meals.

4) Fructans are most likely the most common FODMAP to cause symptoms of IBS (Dr. Sue Shepherd).

5) If your symptoms improve after following the Low-FODMAP diet for two months, it is recommended to slowly reintroduce one FODMAP group at a time to see how well you can tolerate them.

6) On the Low-FODMAP diet, wheat is only a problem ingredient when consumed as a wheat-based carbohydrate food like cereal, breads, or pasta.

7) A low-FODMAP diet is not a gluten-free diet.  When you are on the low-FODMAP diet you can have oats and small amounts of wheat, barley and rye.

8) A fructan is a polymer of fructose molecules. Fructans with a short chain length are known as fructooligosaccharides. Fructans can be found in foods such as agave, artichokes, asparagus, leeks, garlic, onions (including spring onions), yacon, jícama, and wheat.

9) When bacteria in the large intestine receive molecules not absorbed in the small bowel, they break these molecules down quickly.  This produces hydrogen, carbon dioxide and methane gases – otherwise known as unpleasant times for people like us!

10) A lactose-free diet is not a dairy-free diet.  Lactose is present in most dairy products.  The Low-FODMAP diet can benefit those who suffer from lactose intolerance by helping them to reduce lactose intake.

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What is Gastroparesis? Melissa’s Story

melissa's gp fightFODMAP Life is about bringing people together, supporting one another and educating all about the FODMAP Diet, and what it is like for anyone to have digestive or inflammatory health issues.  There’s a new section on our website called “Your Story” and I am so happy to welcome Melissa to our community as she will continue to share her story about living with Gastroparesis, a condition that reduces the ability of the stomach to empty its contents. The National Institutes of Health estimates that 5 million Americans live with Gastroparesis.  John Clarke, M.D., assistant professor of medicine at the Johns Hopkins University School of Medicine  If you would like to submit your story, please submit at least 200 words, plus a short bio and a photo of yourself to: itsafodmaplife {at} gmail {dot} com.

“I owe it all to the desire for self preservation and listening to my body’s needs.”

Melissa’s Story

I go by Melissa “GP Fight” McElfresh in the GP Community. What is GP? It is the shortened version of the medical term Gastroparesis; which basically means Stomach Paralyzed. This is what I have. It is unknown how I got GP, but my best guess is from the extensive whiplash.

For several years (post-whiplash) I experienced pain when drinking water, abdominal pain when bending over and nausea. The nausea was worse during my period, so my doctor would change the birth control pill every six months. She would have other reasons of ‘common’ reasons why I had the other issues.

During the third year I started to have chest pain. Again, the Dr without testing, told me it was Acid Reflux and gave me GERD medication. The fourth year the chest pain got to the point that I thought I had cracked a rib and the nausea was so intense I was trying not to vomit. This was 24-7, for the past few months! I went to the ER, where they ran a lot of tests, didn’t find anything and gave me a higher GERD Rx. The next day I went to my doctor and she ran a few more tests, which all came back clean. She didn’t know what was wrong and decided to send me to a Gastroenterologist who started off with ordering an Endoscope (yep, clean again).

The specialist then wanted to do a Gastric Emptying Study (GES). I told my husband I am DONE spending money on tests that come back fine, I was not going. This was going to cost us close to $2,000!! He convinced me to go. Good thing I did. This was when I was diagnosed with GP. The GI doctor put me on a low-fat and low-fiber diet (common) for six months and asked that I come back if I was not better. She lacked the GP knowledge I needed, so after one year of gaining no ground, I found a new one.

At this point I was vomiting every morning, couldn’t make it full days at work anymore, hair was falling out, I was blacking out, had no energy and in so much pain (felt like a cracked rib). This lasted for 18 months! The new doctor ran some blood work and I was able to add some supplements to what I was trying to ‘eat’. I could only consume 1 cup of food (soft or liquid) every 3 – 4 hrs. We even tried low dose antidepressant; which is believed to numb the stomach nerve endings, reducing pain and nausea. Six different Rxs later, nothing helped.

I ended up loosing my 15 year-old job and unemployment would not take me. Shortly after, we lost our house on the 5.5 acres. Later I filed for disability and lost that too. Even my GI didn’t have anything left for me, until I needed a feeding tube. I was lost and alone with trying to fight gastroparesis.

One day I decided this was not how I wanted to live my life and began to change. Starting with finding my trigger foods (very hard I must say) and then going Gluten and Dairy Free. I don’t follow FODMAP 100%, but fairly close and I can honestly say that I am much better. The pain and nausea are tolerable, no black-outs, no vomiting, energy is better and the dizzy spells are a sign I need protein. I am working two days a week, I set up an on-line store for GP awareness items, and manage several FB Pages.  I volunteer for a few non-profits and blog on my website. I owe it all to the desire for self preservation and listening to my body’s needs.

If you have a GI Track issue, I fully recommend you look at the food you eat and try a low-FODMAP Diet in stages. Please explore my blog at www.MelissaGPfight.com if you want to know more about GP. Thank you for your time!

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