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Nutrition

Client Story of IBS/FODMAP Diet

by Valerie Polley | Jan 17, 2019 | 0 comments

I've suffered from IBS-C since I was 6 years old but I wasn't officially diagnosed until I was 26 or 27. I thought it was normal to be constipated. Throughout childhood, teenage years, and early twenties, primary care and family doctors would instruct me to drink more water, eat more fiber, and take stool softeners. And seriously, I would try my best and it would help for a while and then I would either revert to old habits or get upset because my symptoms would return.

Being constipated was just part of my life and I would only complain if the pain lasted several days. My mom would purchase prune juice and over the counter laxatives to assist me during those instances. In my late teen years, she took me to the doctor because I was having excruciating internal lower back pain. The physician automatically formed his own conclusions and decided that it was a "female issue" and that a pelvic exam must be completed. My mother advised against it and assured him that wasn't the issue. He tried to reassure her that he knew what he was doing and that it would be best for her to leave the room and leave me in the care of the female nurse. I will spare you the details but he quickly gave up on completing that exam and ordered a CT scan instead. Once completed, he returned to my mother with the prognosis.."Sgt., your daughter is full of shit...LITERALLY." And of course I was ordered to take stool softeners twice daily.

I didn't return to the doctor for constipation issues for a decade. I just dealt with it and I discovered magnesium citrate...only to be taken when in dire need and near my bathroom. So after two visits to 2 doctors in my late twenties, I self diagnosed myself with IBS-C. The second doctor informally agreed but stated that I would have to have several more visits before she confirmed. She scheduled a barium enema, told me to eat more fiber, and instructed me to take Miralax. The next doctor officially diagnosed me...no examination needed and instructed me to start taking a powder fiber supplement and drink more water. Fast forward to two more doctors and being prescribed Linzess which wasn't a match for me; my symptons had worsened, the pain had increased, and I often went to bed curled up in a ball crying and praying for the pain to go away. I was a master at hiding my pain all through the work day.

During those painful nights, I started acknowledging that food could be making my pain worse. I'm a foodie so it was the last thing I wanted to admit but one of my friends has UC and can't eat several things including raw vegetables which I noticed had started to affect me. I would like to tell you that after speaking to two of my dietitian friends and reading about the low FODMAP diet that I dove right in. NOT! I was foodie; a YELP elite foodie. Participating in the low FODMAP diet would mean giving up one of my favorite activities...exploring menus at local restaurants. I gave up raw veggies, Lay's potato chips, goldfish cheese crackers, and apples and continued my constipation life.

On my bad days, I would cry myself to sleep in anger and pray for God to take my pain away. On one of those nights, I found myself on IU Health's website. I researched the doctors, searched their faces for compassion, and prayed. I made my appointment and received a confirmation call a few weeks later. When the nurse called to confirm my appointment, I frantically explained to him that I didn't want to come in and be told to drink water, eat fiber, take stool softeners, and try Linzess again. I wanted to be fixed and I wanted a colonoscopy. I left him with quite a impression; the doctor and nurse were ready for me. Yes! Professionals were finally listening. The doctor ordered several tests and after all were complete I didn't get the answer I wanted; there was no magic pill or procedure to fix me.

I did get more information and understanding and that in itself was a blessing. My intestines are working but just very slowly. My intestinal muscles are weak. And constipation is a life sentence for me that will take a combination of things to successfully thrive...70 ounces of water, stool softener, fiber, medicine, probiotics, exercise, stress management, and a modified diet.

The low FODMAP diet has changed my life. While my constipation is still very real, the gas, bloating, and cramping has decreased greatly. My sleepless painful nights occur less and less. I haven't regurgitated food that couldn't find it's way out the other way since I started the diet. No, thriving on this diet isn't always easy. And my foodie lifestyle has had to change but it is so worth it. When I decided to try out this diet, I thought I would be stuck eating rice cakes and bland boiled chicken. This was so far from the truth, with the help of my dietitian, my Facebook support group (Low FODMAP recipes & support), and all the internet low FODMAP dietitians' resources (websites, Pinterest, Instagram) I quickly learned how to make an adventure out of elimination, reintroduction, and modification. I'm loving eating on this diet and all the recipes that I have tried or modified.

The hardest part of living the low FODMAP lifestyle for me has been work travel and eating out but guess what, I'm succeeding in this area too. My dietitian gave me a lists of safe fast food choices; her suggestion of Chipotle seriously saved me from an episode of HANGRY. My FB group gave me the confidence to contact restaurants in advance and most are willing to accommodate, but no worries if they aren't because I always have snacks.

On the plus side, I've never been a fan of eating at people's homes and usually eat before going. Now, I get to bring my own food and have a nice excuse for doing so. And one of the biggest victories was I stopped keeping my pain and digestive disorder a secret, I think this has helped my stress level tremendously.

If you have IBS and are considering the low FODMAP lifestyle, go for it. It's a game changer!

The information in this blog is not a substitute for professional medical advice, examination, diagnosis and treatment. Always seek medical advice from your physician or other qualified healthcare provider before altering your diet, starting a new treatment or making changes to an existing treatment.

Our gut microbiome (the community of trillions of microbes that live in our gut) plays a key role in maintaining metabolic and immune health. Gut dysbiosis occurs when the composition and diversity of our gut microbiome shift. This could include overgrowth of harmful bacteria or a decrease in beneficial bacteria. Gut dysbiosis has been linked to a wide range of negative health outcomes, including increased levels of inflammation and changes in metabolism.

Many people switch to non-nutritive sweeteners like sucralose, aspartame, and stevia for health reasons, and for decades, we've believed that they pass through our bodies without affecting us. But emerging research shows that these compounds interact directly with our gut microbiome and may have potential negative effects on our health. 

This article will review what we currently know about the relationship between non-nutritive sweeteners (including artificial sweeteners and calorie-free natural sweeteners) and the gut microbiome, plus practical advice for navigating sweeteners.

Sucralose

Sucralose (Splenda) is an artificial sweetener commonly used in baked goods, gums, and sugar-free beverages and is approximately 600 times sweeter than sucrose (table sugar). However, recent research has linked it to adverse health effects such as systemic inflammation, metabolic disease, and gut dysbiosis. For example, a 2022 study found that sucralose consumption increased harmful bacteria and reduced beneficial bacteria, which was associated with changes in insulin and glucose levels.

Additionally, a 2025 randomized controlled trial examining the effects of replacing added sugars with sucralose found that people with type 2 diabetes who consumed sucralose experienced reductions in both alpha diversity (the number and types of species present in a single person) and beta diversity (differences in microbial composition between people). Interestingly, the people with overweight and obesity without type 2 diabetes did not experience the same changes.

Overall, animal studies and limited human studies suggest that sucralose may trigger intestinal inflammation, likely through its effects on the gut microbiome. However, since most of the evidence we have comes from test tube or animal studies, these results should be interpreted cautiously.

Aspartame

Aspartame is another commonly used artificial sweetener that is about 200 times as sweet as sucrose. While it does contain some calories, because you don't need much of it to reach the same sweetness levels as sucrose, these calories are negligible.

Like sucralose, most of the research into the gut effects of aspartame has been done in animals. However, we do have some very small human studies. A 2022 randomized controlled trial (RCT) involving 20 healthy adults found that participants taking aspartame showed changes in both probiotic (beneficial) and pathogenic (harmful) bacteria, but the changes were specific to each individual. 

Why the differences? It's likely due to the "responder vs. non-responder" phenomenon. We all have differences in our "baseline" microbiome. While certain bacterial species are common in healthy populations, our microbiome is as unique as a fingerprint. Whether an artificial sweetener has positive or negative effects on our microbiome may depend on which species are already present in our gut, as well as on our habitual diet. This difference in responses makes it very challenging to draw firm conclusions about whether artificial sweeteners are harmful.

Stevia

Many people choose stevia because it's a "natural" zero-calorie sweetener. Studies have shown mixed results regarding the effects of stevia on the gut microbiome. For example, while some in vitro (test tube) and in vivo (animal) studies have reported potentially harmful effects of stevia on the gut microbiome, others have found no impact, and some even reported beneficial effects through inhibition of inflammatory pathways.

Additionally, a 2024 human study found that stevia had no significant effect on the gut microbiome. This highlights the importance of not forming conclusions based solely on test tube and animal studies. Overall, it appears that stevia is a potentially less-harmful alternative to artificial sweeteners like sucralose and aspartame.

Practical Advice for Navigating Sweeteners

Since the research on artificial sweeteners is still evolving, the decision to include or avoid them comes down to personal preference. Here are some tips for including them in your diet in moderation:

  • Try gradually reducing the amount you use: If you typically use two packets of sweetener in your coffee or tea, try gradually reducing to one packet. Our taste buds are highly adaptable, and you may find that one packet is sweet enough once you get used to it.
  • Check your labels: Low- or no-calorie sweeteners (such as sucralose, aspartame, and sugar alcohols like erythritol) are often hidden in low-sugar foods like protein bars, yogurt, and diet sodas. Awareness is the first step to reducing your intake.
  • Rotate your sources: If you do use artificial sweeteners, try switching up the types you use. Since different sweeteners may affect your gut microbiome in different ways, this may reduce the concentrated impact on your gut.
  • Switch to stevia: While animal and test-tube studies show mixed findings, human research indicates that stevia has a limited effect on the gut microbiome, making it a better choice for people seeking to support their gut health.

Another way to support your gut if you regularly use artificial sweeteners is to rebuild gut diversity with fiber and fermented foods, while focusing on whole-food sweeteners.

  • High fiber prebiotic foods (like legumes, whole grains, garlic, onions, asparagus, and under-ripe bananas) act as "fuel" for your healthy gut microbes. Aim to include a variety of these foods in your diet to support the microbes already in your gut.
  • Add fermented foods, like unpasteurized sauerkraut and kimchi, kefir, or kombucha, to your diet. Some fermented foods contain live, beneficial bacterial cultures, while others are rich in "postbiotics" (beneficial compounds like short-chain fatty acids, which are produced when bacteria break down prebiotics).
  • Try using whole-food sweeteners instead of artificial ones. For example, sweeten plain yogurt with vanilla extract and berries or add dates to smoothies or homemade energy bites.

Final Thoughts

Emerging research suggests that certain low- or no-calorie sweeteners, including sucralose and aspartame, may affect the gut microbiome, whereas stevia appears to have a less negative effect. While individual responses can vary with a person's unique baseline microbiome, certain artificial sweeteners may increase inflammation or reduce gut microbiome diversity.

If you need personalized support navigating sweeteners or supporting your gut health, Blue Tree Nutrition can help. Click here to get in touch!

 

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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