Seafood’s Role In A Low FODMAP Diet For IBS

In early 2000 I was nearly finished with my undergrad work in Cultural Anthropology when I started having gastrointestinal problems. At first it was chalked up to diverticulitis, but test, after test, after test, nothing was seen. Since several GI specialists could not find the reason for my abdominal pain and changing bathroom habits, my issue was diagnosed as Irritable Bowel Syndrome (IBS).

For the next 8 years I saw my earning potential fall off a cliff as I lost 3 jobs in that span because of IBS. It forced me to radically change how I lived my life and what led me to falling back on my knowledge of local history and my love of writing to attempt to make a living.

What frustrated me is that all the ”good” advice I got about trigger foods and lifestyle changes didn’t seem to help. In fact for a large portion of time I had manageable symptoms even though I was just going about my business. However I have noticed that the pendulum is beginning to swing and I have not been feeling so great lately.

Is My Irritable Bowel Syndrome Cyclical?

I have told many of my doctors that I believe my IBS is cyclical: when things are bad, nothing helps, but when things are good, I’m bulletproof. This time around I noticed that my IBS was flaring up at the same time that reflux and my sinuses were causing problems.

I had chronic sinusitis which required surgery a few years back, but since that time I have not had a major IBS flare. I found it interesting that both were giving me problems. I decided to look into the connection between IBS, reflux/GERD, and chronic post nasal drip/sinusitis.

Full disclosure: I do NOT buy into alternative therapies and/or homeopathy. I worked in a health-food/alternative medicine store in college so I am well versed in the concepts and tried many of the remedies. Some of that stuff does work, but much of it is untested…at best. Before I try it I need hard, peer-reviewed science.

I was surprised when I found several articles online thanks to Google Scholar, that suggested a link between IBS and sinus problems. One approach that seems to help is something called a low FODMAP diet. A concept that up to that point, had never been suggested by any physician I’ve ever talked to.

What are FODMAPs?

Fodmap infographic
Source: Michigan Medicine

FODMAP is an acronym for the short-chain carbohydrates that can cause IBS symptoms:

  • Fermentables
  • Oligosaccharides
  • Disaccharides
  • Monosaccharides
  • and
  • Polyols

Starting With the Exclusion Phase

I started a low FODMAP diet in June for two weeks before our annual St. Peter’s Fiesta. After that short amount of time, I noticed a difference. There was also an easy correlation that every time I ate food high in FODMAPS during the festival, I felt bloated like I used to. It was easier to get back on track after the holidays and my overall mood improved as well.

Watch Out For Added Ingredients and Thickeners

I’m just about to start reintroducing certain foods back in and I’m already seeing patterns. For instance I have a feeling I will be able to tolerate wheat in small amounts, but not products that have added soy. Although not FODMAPS, I’ve learned the hard way that certain gums like guar and xanthan, added to foods, (especially gluten free and lactose-free ice cream) gives me a real hard time.

Seafood as Part of a Low FODMAP Diet

Like most protein, fish and shellfish are low FODMAP. However depending upon how you like your seafood, you will have to change up your recipes. If you’ve read this blog before, you know I love breadcrumbs, either made from local Italian bread or buttery Ritz crackers. Those are out at least until I start the reintroduction phase. Same for onion, garlic and mushrooms. However I’m not really missing them as much as I thought.

Dover Sole

Something as exquisite as Dover Sole Meunière can be modified for a low FODMAP diet, by using plain gluten-free flour or an alternative like corn, rice or buckwheat. Just make sure you can tolerate butter.

When it comes to fish, the low FODMAP diet is perfect for the grill or grill pan. Swordfish, tuna, salmon, barramundi, striped bass, mahi…all of them are great on the grill. Flaky fish, especially if using skinless fillets, can be grilled or baked in a foil pouch along with FODMAP friendly ingredients.

Shellfish lovers can still enjoy oysters, clams, scallops, lobsters and more. However, your steamers and mussels will have to omit any garlic or onion. Fortunately the traditional can of beer or glass of wine should still be fine for the steaming liquid. Keeping in mind that alcohol can be a gut irritant. For the fried clam lovers out there, a breading made of corn meal is low FODMAP, but most places use some wheat flour.

If you go out to an old school fish shack style restaurant, the fried seafood may be tolerable. Many places use a simple cornmeal breading and just a quick dip in evaporated milk. If you are worried, get a smaller portion to share. That way you satisfy your craving without causing too much stress.

If you omit the onion and garlic, and use lactose-free milk or cream, you can even make a chowder. Instead of using oyster crackers, get yourself an artisan loaf of sourdough bread (make sure it’s made with a sourdough starter, no yeast).

Keep Seafood Recipes Simple and FODMAP Friendly

Simple preparations of olive oil, lemon, salt and pepper are great on all kinds of fish. Nearly all herbs and spices are OK as well, just make sure you check the ingredients before using spice blends or rubs, they usually have garlic and onion powder in them. Sorry Old Bay fans, but there are all sorts of FODMAP friendly spice blends available, including low FODMAP seafood seasonings.

I recently had a couple of seafood meals that contained potentially high FODMAP ingredients: Baked scallops and fried clams. The breadcrumbs and herbs on the scallops did give me a feeling of bloatedness shortly after eating, but no long term effects. The fried clams even less so, since the breading is lightly seasoned and has a high ratio of cornmeal, which is low FODMAP. However it does not take long to get back to the new ”normal” so you don’t have to beat yourself up if you’re finding yourself eating things with high FODMAP ingredients…just don’t make it a habit in the initial phase of the diet.

Get the Facts on FODMAPS

If you are interested in getting started on the low FODMAP diet take a look at the Monash University FODMAP website. They also offer an app to help you sort out what you can eat during the phases of the diet. You should also notify your primary care physician, they may be able to offer insight into how to stay healthy: for some, this diet is not a major change, but for others it is significant. You have to find alternative sources for things like vitamins, calcium and especially dietary fiber.

As I find my way through this new diet, I will make sure to be clear if foods or recipes I try are low FODMAP. If you are an advocate of the low FODMAP diet, and a lover of seafood, please share your experiences in the comments below!