Low FODMAP Foods for Bowel Emptying
For patients needing bowel emptying support while following a low FODMAP diet, fresh tomatoes, polyethylene glycol-based laxatives, and magnesium-containing products are excellent alternatives to beetroot. 1, 2
Dietary Options for Bowel Emptying
Low FODMAP Vegetables
- Fresh tomatoes can be consumed freely during the restriction phase as they lack the problematic short-chain fermentable carbohydrates that trigger gastrointestinal symptoms, making them an ideal replacement for beetroot 2
- Tomatoes provide fiber and nutrients without FODMAP content, unlike high FODMAP vegetables such as onions and garlic which must be avoided 2
Fiber Considerations
- Soluble fiber supplementation is efficacious for treating global IBS symptoms, particularly in constipation-predominant IBS, though you must ensure adequate fluid intake when increasing fiber to prevent constipation 2
- The low FODMAP diet should maintain adequate fiber through low FODMAP alternatives rather than complete restriction 2
Medical Management Options
Laxatives for Bowel Emptying
When dietary measures alone are insufficient, the American College of Cardiology recommends several laxative options that are compatible with a low FODMAP diet 1:
- Polyethylene glycol (osmotic laxative) - does not contain FODMAPs 1
- Magnesium-containing products - osmotic effect promotes bowel movements 1
- Senna - stimulant laxative option 1
- Linaclotide or prucalopride - prescription options for more resistant cases 1
Implementation Strategy
Practical Approach
- Replace beetroot with fresh tomatoes in meals to maintain vegetable intake while supporting bowel function through fiber content 2
- Consider calorie-dense supplements and shakes if weight loss or malnutrition is a concern, as these can be formulated to be low FODMAP 1
- Ensure adequate hydration when using any fiber-containing foods or supplements, as insufficient fluids can worsen constipation 2
Professional Supervision
- Referral to a registered dietitian with gastrointestinal expertise is strongly recommended for implementing the low FODMAP diet, as the diet can be complex and requires careful food selection 2, 3
- The British Society of Gastroenterology suggests that 78% of IBD patients with functional symptoms reported satisfactory relief with a low FODMAP diet under dietitian supervision 1
Important Caveats
Microbiome Considerations
- Strict long-term FODMAP restriction may negatively impact the intestinal microbiome, particularly reducing beneficial bifidobacteria, so the diet should not be continued indefinitely in its strictest form 2
- Research shows that a low FODMAP diet can reduce fecal abundance of Bifidobacterium adolescentis, Bifidobacterium longum, and Faecalibacterium prausnitzii 4