So you followed the Low FODMAP diet for 2-6 weeks… and still didn’t notice any improvements? If this sounds familiar, make sure you check out my recent post about the 3 reasons why the low FODMAP diet didn’t work for you. If none of those reasons apply to you, you may be in the 20-40% of the population that doesn’t respond well to a low FODMAP diet. 

A low FODMAP diet is effective for the majority of patients with IBS (60-80%), but there are still 20-40% of people who don’t respond well to it. So, what does that mean? Does that mean there is nothing you can do about your symptoms if you are in that 20-40% of people? Absolutely not. It just means you may need to go down another path to find relief. Before we dive into that, first it’s important to investigate the following and be honest with yourself… 

Did you follow the diet properly? There are a lot of reasons why you may not have followed the diet properly, most of them are likely unintentional. For instance, if you eat out regularly, eat a lot of processed foods, or tend to overeat at your meals, then you may be eating more FODMAPs than you think. This alone could lead to ongoing stomach symptoms and a (false) conclusion that maybe the diet just didn’t work for you. 

Tip: Keep a detailed food log during your entire elimination diet. A dietitian will be able to look through your food log and assess whether you implemented the diet properly, or whether (often unintentionally) you consumed more FODMAPs than intended, which led to ongoing symptoms. 

Have other gastrointestinal issues been ruled out? It is always a good idea to rule out other gastrointestinal (GI) issues, such as celiac or Crohn’s disease, before implementing a low FODMAP diet. If this wasn’t previously ruled out and you are still dealing with symptoms after the low FODMAP diet, it’s probably time to get checked out by a doctor.  

If you did follow the diet properly and other gastrointestinal issues have been ruled out, then you may truly be in the 20-40% of people who don’t respond well to the low FODMAP diet. Again, this doesn’t mean you’re stuck with your symptoms forever. 

This would be a good time to pair up with a healthcare professional or trained FODMAP dietitian to identify other therapies that could help target your symptoms. For instance, cognitive behavioral therapy or gut-directed hypnotherapy may be helpful if stress plays a major role in your symptoms. Fiber supplementation may be helpful if you have persistent diarrhea or constipation. Over the counter therapies, such as laxatives, probiotics, or peppermint oil may also be helpful in some situations.  

The low FODMAP diet is not the end all be all to your stomach issues. It isn’t helpful to everyone with digestive issues. But it is helpful for the majority of people who suffer, which is why it’s a great place to start. 

If you find that you responded poorly to a low FODMAP diet, it would be worth talking to your doctor or dietitian to discuss other therapies that may be helpful for you. No one should be stuck with digestive issues that don’t improve — there is always something else to try. And there is always hope.