- The FODMAP reintroduction plan is the only way to learn
what your individual tolerance level
is to different FODMAPs.
And it's the only safe way
to reintroduce some of your favorite foods as well.
But in order to be successful it must be approached
in a systematic fashion and that's
what I'm looking at in this video.
(various bell tones dinging)
Reintroducing FODMAPs is the second part
of a low FODMAP diet after the elimination phase.
It's also known as the challenge phase,
reintroduction phase, or challenge protocol.
The terms reintroduce and challenge or re-challenge
are used interchangeably.
Now following this plan enables you to discover
what exact FODMAPs trigger your IBS symptoms.
By the end you should have a great understanding
of what foods you can and cannot tolerate,
and in what quantities.
There are many guidelines to follow and it's strongly
recommended that you do this with a
FODMAP trained dietitian where possible.
Okay, so how does it actually work.
There are 10 FODMAP groups to be reintroduced,
one at a time.
This must occur over a three day period
with three washout days inbetween groups.
That is certain days where you completely return
to a low FODMAP diet in order to reset
your digestive system.
A typical schedule may look like this
although this is just a generalization.
And in this case re-challenge is used
interchangeably for reintroduce.
So, if you are re-challenging for three days
and leaving a three day washout period,
re-challenge process for one group lasts almost a week.
That means 10 FODMAP groups will take
nine to ten weeks total assuming no setbacks.
If you do experience symptoms,
you must wait until they settle back down.
Now usually the three day washout period
is enough time but not always.
And know that you should not reintroduce
any new FODMAP groups until you are
completely symptom free or
as close to symptom free as you can get.
It's also important that during this period
you continue to follow a low FODMAP
eating pattern the entire time.
The most appropriate foods to reintroduce for each group
are those that contain only one FODMAP group.
This insures that if you do have a reaction
it's obvious what FODMAP was the culprit.
There are five separate re-challenges for fructans
because they occur in a wide variety
of fruits, vegetables, and grains.
Fortunately, there's only one re-challenge
for each of the remaining FODMAPs.
So, here's an example of a full schedule to follow
from FODMAP trained dietitian Lee Martin
which is on the website alittlebityummy.com.
Now it contains recommended foods and quantities
so you can see re-challenge one is fructose.
So, in this example you would gradually
reintroduce honey for three days
and record if you get symptoms.
And then you would have three days of washout period.
So there would be no honey and continuing a low FODMAP diet
before moving to re-challenge two.
Now you can start with whichever group you wish but
it may be easy to start with lactose or fructose.
They're quite straightforward.
Additionally, I usually recommend re-challenging
in the early evenings, at home.
There's no possibility of being caught out when at work
and allows enough time to notice symptoms before bed.
Now, a common question is how long will it take
for symptoms to show after you
do reintroduce a new FODMAP group.
Now, this varies between individuals and of course depends
on the severity of the reaction
if there is indeed a reaction.
Patients report symptoms from anywhere between 30 minutes
till the next morning up until two days later.
Just like in the elimination phase,
it's critical that you keep a food and symptom diary
throughout the entire reintroduction plan.
So, that is recording what you ate,
how much you had,
and what were the symptoms if there were any
because this helps you identify any sort of
patterns or trends that you might have otherwise overlooked.
While I've touched on the fundamentals,
it's much easier to do all this
if you have a complete reintroduction protocol to follow.
Now, if a FODMAP trained dietitian is not available to you
I recommend the reintroduction book by Lee Martin
which I'll link to in the video's description.
Alternatively, you can visit my
reintroduction guide on Diet vs Disease
which I'll also link to in the description.
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