Page 25 - Layout 1

HEALTHY
EATING

credibly common. In the absence of red flag
symptoms, initial management may involve
avoidance of carbonated beverages, chewing
gum and poorly digested carbohydrates.
Constipation should not be overlooked, as it
can be simple to treat in many cases. Diets
like the Low FODMAP diet or elimination
diets with consultation of a registered dieti-
tian, especially in young and otherwise
have additional symptoms of abdominal mation with gas production and often with healthy patients, may be a reasonable next
cramping, constipation and/or diarrhea. The resultant symptoms of bloating. Some exam- step. Otherwise, additional workup and
Low FODMAP diet has shown to be an ex- ples of these are foods that contain fructose medical management with a gastroenterolo-
cellent cost-effective option as an initial “best like honey, high-fructose corn syrup, apples, gist can be helpful to diagnose and treat al-
step” in management and evaluation. This is pears, mangoes, cherries and wheat. The ternate etiologies like GERD, Helicobacter
especially true in younger and otherwise FODMAP diet involves elimination of these pylori, peptic ulcer disease, gastroparesis, bac-
healthy patients without “red flag” symptoms foods for 6-8 weeks and then, upon symptom terial overgrowth and more.
like melena, hematochezia or weight loss. improvement, slow categorical reintroduction
High FODMAP foods include other short- of foods helps to identify intolerances or trig- Chirag Patel, MD is a Gastroenterol-
chain carbohydrates that are poorly absorbed gers contributing to symptoms. ogist in Bexar County and a member
in the intestine as well, leading to rapid for- Belching, bloating and flatulence are in- of the Bexar County Medical Society.

Visit us at www.bcms.org 25