Do you ever feel like the food you eat is working against you?

For a number of years, I was suffering from severe bloating and constipation. It got so bad it was significantly impacting my health and happiness.

I had seen an incredible number of doctors and gastroenterologists. I had also been put through a lot of tests and prescribed all sorts of medication without any of it truly helping. It wasn’t until I finally found the root cause of my problems that my symptoms largely disappeared.

I tell you: it’s a brand new, happier, and more comfortable world for me.

Bloating, Constipation and Diabetes: How I Fixed My Stomach Problems

Key Points:

  • Issues such as bloating and constipation may be attributable to a FODMAP intolerance, a condition in which certain carbohydrates are linked to poor absorption and fermentation in the gut, leading to digestive problems.
  • Effective management of digestive issues can be achieved through a structured elimination and reintroduction diet. This approach can help identify specific foods that trigger symptoms, significantly improving gut health and overall well-being.
  • While FODMAP intolerance is not directly linked to diabetes, it’s crucial to consider FODMAPs in dietary choices, particularly if you have diabetes and IBS (irritable bowel syndrome), due to the frequent co-occurrence of these conditions.
  • Self-advocacy and proactive research are crucial, especially in cases where conventional medical treatments fail to offer relief. Personal research and self-advocacy can play a vital role in discovering effective health management strategies.

Bloating, constipation, and diabetes: my experience

Constipation is typically defined as:

  • Having fewer than three bowel movements a week
  • Stool that is dry, hard, or otherwise difficult to pass
  • Discomfort or bloating along with bowel movements

After all the specialists I had seen, it ended up being my husband who found the right diagnosis for my bloating and constipation via a Google search of my symptoms. Usually, I really don’t recommend this approach, but the medical system had frankly failed me this time.

In people with diabetes, bloating, constipation, nausea, and other digestive issues can be caused by a complication known as gastroparesis, a condition in which damage to the nerve that controls the stomach muscles can slow stomach emptying. 

Additionally, certain medications used for treating diabetes, such as metformin, sulfonylureas, thiazolidinediones, and alpha-glucosidase inhibitors, can be linked to gastrointestinal side effects such as constipation.

And then, of course, there’s the possibility that there may be a cause or condition unrelated to your diabetes that is resulting in the bloating and other digestive difficulties, such as dehydration, low fiber consumption, or a gastrointestinal issue like gastroesophageal reflux disease (GERD).

In my case, it turned out I have a FODMAP intolerance. Common symptoms of FODMAP intolerance include

  • Cramping
  • Diarrhea
  • Constipation
  • Stomach bloating
  • Gas and flatulence

By doing a 6-week elimination of specific foods and a 4-week reintroduction, I was able to identify the items my body disagrees with and reduce or eliminate them from my diet.

Now, nearly all of my digestive issues have been resolved.

What are FODMAPs?

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

In simpler terms, FODMAPs are certain types of short-chain carbohydrates (sugars) found in some foods. The issue for people intolerant to FODMAPs is that these sugars can’t be absorbed in the small intestine. 

Instead, they are fermented (broken down) by bacteria living in the colon, creating gas and bloating. For some people, this can cause symptoms such as constipation or diarrhea.

The tricky part about understanding this is that not all sugars are FODMAPs, and it’s not intuitive which ones are. I ended up buying the Monash University FODMAP Diet App so I could look up foods on the go.

Also, to make things even more complicated, it’s possible to have an intolerance to some but not all FODMAP foods.

Some of the worst offenders for me are onions, garlic, and mushrooms. Although those are generally healthy foods, my body simply can’t deal with them. 

There is no cure for FODMAP intolerance, so the only solution is to simply cut the offending foods out of your diet or consume very limited amounts.

Common sources of FODMAPs

According to the Monash University FODMAP Diet App, some common sources of FODMAPs include:

  • Foods with more fructose than glucose (e.g., apples, cherries, peaches, pears, and many other fruits; honey; high-fructose corn syrup)
  • Lactose (milk and milk products)
  • Sugar polyols (sweeteners containing sorbitol, mannitol, xylitol, maltitol, and some fruits and veggies)
  • Fructans (a type of carbohydrate found in wheat, rye, onions, and garlic)
  • Galacto-oligosaccharides (prebiotics, a type of dietary fiber that feed the beneficial bacteria in the gut, found in legumes such as beans and lentils)

For me, cutting the biggest offenders out of my diet has made a world of difference to my gut health and overall happiness.

How to diagnose a FODMAP intolerance

The best way to diagnose a FODMAP intolerance is to simply cut all high-FODMAP foods out of your diet for a while and see what happens to your digestion. 

This diet is quite restrictive and isn’t intended to be maintained long-term, but it can help you pinpoint what foods may be negatively affecting you.

If you see a significant improvement, there is a good chance you are intolerant to at least some FODMAP foods. (And if you don’t see an improvement, there’s likely no need to continue testing the low-FODMAP diet.)

Also, it’s worth noting that if you have a condition such as small intestinal bacterial overgrowth (SIBO), you may feel worse on the elimination phase before you feel better as the overgrown bacteria die off.

After about 2 to 6 weeks of elimination, you can start systematically adding potential problem foods back into your diet one by one over the course of about 6 to 8 weeks. Add a single food (such as onions) for 3-4 days and see how your digestion reacts. If everything is still OK, then you can probably tolerate that food.

In between testing foods, you’ll revert back to the strict diet to avoid overlapping effects from multiple foods.

If you aren’t sure how to do an elimination diet, it is generally recommended that you do it in collaboration with a registered dietitian (RD) to ensure that you get all the nutrients you need. 

If they are also a Certified Diabetes Care and Education Specialist (CDCES), they can also help ensure your blood sugar stays within target range as you’re adjusting your diet.

And even if you are familiar with the steps of an elimination diet, it’s always a good idea to check with a healthcare professional before you start. There may be other potential avenues you can explore before trying the diet, and they can help you plan a proper menu if you do move forward with an elimination diet.

Just be aware that FODMAP foods are cumulative. This means that you may be OK with small amounts of some FODMAP foods but have problems if you eat several of them together or in larger amounts.

It definitely takes a while to figure out what you can and cannot tolerate, but I can tell you from my experience that it’s so worth it.

Final thoughts

FODMAP intolerance is not unique to people living with diabetes. There is no known physiological connection between the two. But given that diabetes and IBS (irritable bowel syndrome) often go together, I think FODMAPs are worth paying special attention to if you have diabetes.

I lived with severe FODMAP intolerance symptoms for more than 10 years without any of the specialists I saw ever suggesting a food intolerance. That blows my mind!

And know that FODMAPs aren’t “alternative” science in any way. They are very well researched — Stanford’s Digestive Health Center even has specialists on the low-FODMAP diet and how to identify triggers.

As with everything in life, I believe knowledge empowers us. Knowing how we react to certain foods can enable us to make the right choices to have a happy and healthy life. Constipation and diabetes don’t have to go hand-in-hand!