4 Diets for Gut Disorders: How to Understand Them Better

There are 4 recommended diets for gastrointestinal disorders:

• Specific Carbohydrate Diet (SCD)
• low FODMAP Diet
• SIBO Specific Food Guide
• Low Fermentation Diet

The Specific Carbohydrate Diet (SCD) includes monosaccharides but excludes disaccharides, and most polysaccharides. The monosaccharides include glucose, fructose, and galactose. Fruits are good sources glucose and fiber such as oranges and pears. Beneficial fructose is found in fruits but not in commercial fructose products such as corn syrup, jams, and candies. These products contain excessive glucose. Galactose is found in milk and cheese. Vegetables are good sources of fiber, especially cabbage that is beneficial to patients with Crohn’s disease. It heals gastrointestinal damage. Soaked beans and lentils are allowed. Meat is also allowed in this diet. Eggs, honey, butter, oils, and nut flours are allowed. This diet is designed to promote restoration of healthy microbiome. According to hypothesis, consumption of monosaccharides helps digestion and absorption of food. Disaccharides and most polysaccharides are hard to digest for patients with digestive disorders. It is believed that SCD gives volume to the gastrointestinal microbiome and decreases intestinal inflammation. In pediatric Crohn’s patients, 90% moved up in weight percentile following strict SCD.

The low FODMAP Diet was created by Monash University. The mnemonic FODMAP stands for fermentable, oligosaccharides, disaccharides, monosaccharides, and, polyols. It includes fructose, lactose, fructans (in wheat, onions, and garlic), galactans (legumes), and polyols (sugar alcohols). FODMAP may cause symptoms such as bloating, gas, and diarrhea. These carbohydrates reach large intestine without being digested. They draw water into the digestive tract and undergo fermentation by bacteria that reside in the large intestine, leading to bloating and gas. Low FODMAP alleviates overgrowth of bacteria.

SIBO Specific Food Guide is a diet plan to reduce remission of irritable bowel disease, celiac disease and SIBO. This guideline begins with no beans or raw foods. Allow at least 4 hours between meals and a 12-hour fast overnight to allow the migrating motor complex to function optimally.

Cedars/Sinai/Low Fermentation is the diet that allows most grains and potatoes but limits the quantity of starch.

Here’s my perspective about these diets:

Excessive sugar easily ferments in the digestive tract and provides food to microorganisms. Therefore, many diets focus on reducing intake of sugar. Generally, human body needs fruits, vegetables, nuts, seeds, and grains. We need to eat 80% raw foods and 20% cooked food. Raw salad like lettuce, cucumber, and kale are beneficial because they have intact enzymes. It helps digestive system to process food easily. Vitamin C is gone once the food is cooked. Many enzymes are destroyed during the cooking process. For people with digestive disorders, I will limit hard-to-digest foods like beans, meat, and dairy. Meat and dairy have many bacteria. I will eliminate these foods in the early phase of treatment. I will incorporate fresh vegetable and fruit juicing for 6-8 weeks to combat nutritional deficiencies. Underweight patient needs to eat grains like rice (black, brown, and red rice but not white rice). After this period, I will slowly add beans and legumes but not meat and dairy. No snacking for 4 hours, only drink liquids after 1-2 hours after meal. This allows the digestive system to rest so that it is more functional when you eat your next meal. It also enhances the migrating motor complex (MMC), which is responsible for moving debris and bacteria down to the ileocecal valve during fasting at night and between meals. It is a protective mechanism against SIBO for proper small intestine motility. If symptoms subside and tests are all negative, meat and dairy can be added but do not eat them in excess daily.

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