Help for Irritable Bowel Syndrome: SCD, GAPS or Low Fodmap Diet for IBS?
Sadly, if you have irritable bowel syndrome and have visited mainstream doctors, they only know how to give you bandaids for your symptoms, and those are rarely much help. If you've done your own research or visited a natural health practitioner, you've probably been led to the SCD, GAPS, or the Low Fodmap Diet, but which one is best if you are ready to finally get better? Today you'll hear from my blogging friend, Suzanne, who is guest posting today and explaining the differences between those diets. Here's Suzanne…
In this article, I will approach each of these diets in the order in which they were created because it is important to understand how our knowledge of food technology has expanded in recent times.
The Specific Carbohydrate Diet (SCD)
This diet was developed initially by Sidney V. Haas (1870–1964) in the 1920s as a treatment for celiac disease and inflammatory bowel disease, and described in his medical textbook, The Management of Celiac Disease. Later, biochemist Elaine Gottschall, the mother of one of Haas's patients, wrote a book in 1987 called Breaking the Vicious Cycle: Intestinal Health Through Diet which explains the diet and how to go about implementing it.
The Specific Carbohydrate Diet (SCD) controls the types of carbohydrates that are consumed. It allows the monosaccharides (fructose) but not the disaccharides (lactose) and polysaccharides. The belief was that monosaccharides have a single molecule structure that allows them to be easily absorbed through the wall of the small intestine while the complex carbohydrates are not easily digested and so allow the harmful gut bacteria to feed on them, which expands their numbers and causes symptoms. The idea of the diet is that it provides no food for these bacteria and therefore starves them, and so restores a good balance in the gut microbiome (the number and mix of bacteria living in the gut).
Permitted foods on the SCD are unprocessed meats, fish, most fresh fruits and vegetables, aged cheese, eggs, butter, certain legumes, nuts and nut flours, homemade yogurt that has been fermented for at least 24 hours, and honey. Prohibited foods include cereal grains, potatoes, starches, and most dairy products.
The GAPS (Gut and Psychology Syndrome) Diet
The GAPS Diet is an offshoot of the earlier SCD diet and is the invention of Dr. Natasha Campbell-McBride. She believes that the imbalance of gut bacteria is the cause of multiple health problems including autism, ADD, OCD, schizophrenia, epilepsy, depression, IBD, IBS, urinary tract infections, anemia, food allergies and asthma. The overall idea is that these problems are caused by the leaking out of some bacteria and their toxins and incompletely digested proteins and fats through the intestinal lining, where they are able to enter the bloodstream and move to the brain. She calls this a Leaky Gut.
While this theory of a leaky gut has not been proven through any scientific studies, there are many anecdotal stories from moms who have seen significant improvements on the GAPS Diet and there is a reputable line of thinking that those with autism, depression and learning disabilities often have food sensitivities and altered gut microbiome. However, there is still no evidence that altering the microbiome can cure autism. But the developments in this area of research are expanding rapidly.
The diet, which eliminates polysaccharides (the complex carbohydrates found in grains), starchy veggies, lactose, and sugar, has several stages starting with the introduction diet which is for healing the gut lining. This stage consists of homemade soups, bone broths, soft tissues like marrow and probiotic-rich sauerkraut juice. Then meats, raw egg yolks, ghee, and cooked vegetables are added in, followed by fermented veggies, homemade yogurt, whey and kefir, with the final stage including fruit and grain-free baked goods. The theory is that after a year or so on this diet, the gut heals, a balanced microbiome is established and the relevant health problems are solved. (More here on the GAPS Diet.)
The Low Fodmap Diet
The Low Fodmap Diet is the latest evolution of the SCD and GAPS diets. It was developed at Monash University in Melbourne by Dr. Peter Gibson and Dr. Sue Shepherd and has been scientifically proven to significantly help 75% of people with irritable bowel syndrome (IBS).
Fodmaps are short chain carbohydrates, which are poorly absorbed in the small intestine. These include monosaccharides (fructose), disaccharides (lactose), oligosaccharides (both fructo-oligosaccharides and galacto-oligosaccharides) and polyols (sorbitol and mannitol). The science says that in those with IBS, the carbohydrates with a high Fodmap content don’t get well absorbed in the small intestine and travel down into the large intestine where they get fermented by the bacteria there, resulting in the typical IBS symptoms of uncomfortable bloating along with either diarrhea, constipation or a mix of the two. To stop this happening, all foods with a high Fodmap content are eliminated for a period of time during the elimination diet. Once the symptoms have disappeared, the reintroduction stage of the diet is started to test which high Fodmap foods can be added back in and at what level. A person doesn’t necessarily react to all the Fodmap groups. They might even only have a problem with one group like fructose but tolerate the others well. The only way to discover this is to eliminate all high Fodmap foods and then reintroduce them slowly and carefully.
Now that we have a brief explanation of each diet, let’s compare them…
Differences and Similarities
First of all, in general, GAPS focuses on digestive and brain issues and also auto-immune problems, while the SCD and low Fodmap diets target gut conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). GAPS is used to heal a leaky gut, SCD is for killing off pathogenic bacteria and the low Fodmap diet is for eliminating IBS and IBD symptoms while helping fibromyalgia, joint pain, headaches and the other side effects of having a disrupted digestive system.
All these diets focus on carbohydrates to one degree or another. The GAPS diet, at least initially, eliminates all grains, starchy vegetables and sugars except those in fruit and lactose. The SCD diet eliminates disaccharides, polysaccharides and processed sugars but allows monosaccharides (fructose), while the low Fodmap diet initially reduces the intake of all carbohydrates to those low in Fodmaps, but then expands to include those higher Fodmap foods according to how well they are tolerated.
While the GAPS diet is a healing diet that only lasts one or two years, the SCD diet requires absolute adherence to the diet over an extended period of time, and the low Fodmap diet is about discovering at what level the individual can tolerate foods containing Fodmaps through the elimination and reintroduction stages. Recent research has shown that we can’t stay on a diet which restricts Fodmaps long term because we get prebiotics from high Fodmap foods, and they are necessary for balancing the bacteria in the gut. So we need to introduce back into the diet those we can tolerate even if only in small amounts.
Both the GAPS and SCD diets allow honey while the low Fodmap diet does not. Honey has a higher percentage of fructose (monosaccharide) than glucose and that excess is not absorbed in the small intestine by many people with IBS or IBD and so moves on down into the large intestine, where it is fermented, causing symptoms. This difference is due to recent studies on dietary fructose intolerance as a cause of GI symptoms. These advances in food technology had not happened at the time when the SCD and GAPS diets were developed. We now know that monosaccharides have to be looked at as well as disaccharides and polysaccharides. With this new knowledge, many fruits that we know are high in fructose like apples, which are allowed on the other two diets, are not permitted on the low Fodmap diet.
The low Fodmap diet allows small amounts of granulated sugar while the other two diets don’t. We know now that fructose is actually well absorbed when an equal amount (or greater) of glucose is present at the same time, as for example in granulated sugar, maple syrup and rice bran syrup.
As the knowledge in food technology has expanded, diets of necessity have had to change, and the low Fodmap diet is the latest evolution in the area of carbohydrate restriction.
However, we are all individuals and you have to find your own perfect diet which may not be any one of these in its entirety. It is exciting to see where the next step will be as research and experimental studies continue. We are very lucky that there are finally solutions for those of us who have suffered for decades without an answer in sight.
Suzanne Perazzini is the author of two low Fodmap cookbooks, Low Fodmap Menus and Low Fodmap Snacks. She lives in New Zealand in a house overlooking the Pacific Ocean with her husband and son. Since discovering the low FODMAP diet, her irritable bowel syndrome issues, which she has suffered from all her life, have all but disappeared. Her blog, www.strandsofmylife.com, focuses on the low FODMAP diet and features videos, recipes and articles on irritable bowel syndrome and the diet. Her mission in life is to help those who suffer from IBS to implement the low Fodmap diet and to integrate it into their lives.
Related posts you might like:
- Know anyone who needs this info? Do you suffer from digestive issues?
- More on the GAPS Diet: What is the GAPS Diet?