Stacking – What It Is and How To Handle It

The Tummy Clinic | January 14th, 2023

It’s time to clear the confusion around stacking. Read on for additional information on low FODMAP options for holiday food.

FODMAPs, as we know, are types of carbohydrates found in certain foods, including wheat and beans. Studies have shown strong links between FODMAPs and digestive symptoms like gas, bloating, stomach pain, diarrhoea, and constipation. Low FODMAP diets can provide remarkable benefits for many people with common digestive disorders. When people say FODMAP diet, they generally refer to a diet low in FODMAPs. This diet is designed to help people with irritable bowel syndrome (IBS) and/or small intestinal bacterial overgrowth (SIBO) figure out which foods are problematic and which foods reduce symptoms.

FODMAP stacking, as defined by Monash researchers, refers to how FODMAPs can ‘add up’ in our gut. This means you could ingest a small amount of FODMAPs and not experience any IBS symptoms; however, if you eat more of the exact same food(s), you ingest a greater amount of FODMAPs, and could develop IBS symptoms.

When following the low FODMAP diet, we consume amounts of foods in their various FODMAP levels. These can be broadly determined by using the Monash University Low FODMAP Diet Smartphone App or the FODMAP Friendly App. It provides information about what serving sizes of a particular food will be low FODMAP according to lab testing.

Monash University presents the traffic light system (Green for Low FODMAP; Yellow for Moderate; Red for High FODMAP). Most times, it indicates which individual FODMAP is involved. FODMAP Friendly has a system which always lists each type of FODMAP, as well as percentages of those FODMAPs, which can be used to assess stacking on a more micro level.

In one sitting, the total amount of FODMAPs consumed (be it from fructose, fructans, lactose, GOS or sugar polyols) influences whether the meal is tolerated or whether symptoms are induced. It allows people to include more than one ‘green serve’ of food per sitting. The Monash FODMAP Diet App green light cut-offs allow for safe combinations of multiple foods together in a meal.

Understanding FODMAP Stacking

FODMAP stacking refers to IBS symptoms possibly occurring due to consuming multiple “green” FODMAP servings of foods. This usually happens when they contain amber and red amounts of FODMAPs in higher quantities. Thus, the total amount of FODMAPs eaten in one sitting/ meal gets ‘stacked’ up.

Stacking refers to the consumption of foods of not only the same type of FODMAP but any type of FODMAPs.

Tips To Avoid Stacking

The concept of stacking generally relates to a single sitting or meal. This assumes that meals are spaced out over the day, with at least 2-3 hours between each meal or snack. This allows food to be digested between meals and slows the rate at which the gut is exposed to FODMAPs. Here are some simple tips to avoid stacking…

First of all, if your symptoms are well controlled, you don’t need to start worrying about stacking. Consider FODMAP stacking if you notice that while a low FODMAP diet has improved most of your symptoms, you still experience some symptoms even though you are only eating low FODMAP foods.
It’s important to space out your meals. A gap of 2-3 hours should be maintained between meals and snacks to avoid potential additive effects.
Consume naturally low FODMAP foods for example protein foods like eggs, meat, fish, grains like rice or vegetables like carrots.
Include low FODMAP, protein and fibre-rich foods with each meal or snack to help you feel full. Snack ideas can include a small handful of nuts such as almonds or walnuts, fruit like orange or banana, low lactose yoghurt, cheese, a small tin of salmon or tuna, boiled egg, or plain popcorn.
Maintain a food and symptom diary to keep track of issues. This will also help you notice if you are constantly snacking, or eating shortly after a meal, for reasons other than physical hunger. Working with a GI dietician who specializes in using a FODMAP diet is the best way to work out what your individual IBS triggers are, and whether FODMAP stacking is an issue for you.
Even if foods have amber or red lights for larger serve quantities, they can be safely consumed in green serving sizes combined in one meal without fear of triggering symptoms.

Frequently Asked Questions

What to Eat When You Have IBS with Diarrhea: Tips for Relief

Managing IBS with diarrhea can be challenging, but making the right food choices can help. Here’s what works for many people with IBS:

Low FODMAP diet: This dietary approach helps reduce symptoms like diarrhea, bloating, and stomach pain. It involves removing certain foods and gradually reintroducing them to see which ones trigger your symptoms.
Easy-to-digest foods: Stick with foods like plain rice, cooked carrots, zucchini, and lean proteins (e.g., chicken, fish) to ease digestion.
Avoiding triggers: Steer clear of fatty, spicy, or fried foods, as well as dairy and caffeine. These can worsen symptoms for many people with IBS.

If you’re unsure which foods work for you, consulting with a healthcare provider can help you create a personalized meal plan.

What Causes Bloating, Gas, and Stomach Pain in IBS?

Bloating, gas, and stomach pain are common in IBS. These symptoms often result from:

Gas buildup: Undigested food or fermentation in the intestines can cause gas and bloating.
Gut motility issues: In IBS, food may move too quickly or slowly through the digestive tract, leading to discomfort.
Food sensitivities: Certain foods like high FODMAP foods can cause bloating or pain.

Managing these symptoms typically involves diet modifications, stress management, and finding the foods that work best for your body.

How to Manage IBS-Related Constipation

IBS constipation can be tough, but there are ways to improve bowel movements:

Increase soluble fiber: Foods like oats, bananas, and carrots can help soften stool.
Stay hydrated: Drinking plenty of water helps keep things moving.
Exercise regularly: Physical activity helps stimulate digestion.

If these strategies don’t work, gentle laxatives or stool softeners might be considered, but always under the guidance of a healthcare professional.

What Foods Trigger IBS Symptoms?

Certain foods can make IBS symptoms worse, including:

High FODMAP foods: These include foods like onions, garlic, certain fruits (e.g., apples, watermelon), and dairy.
Fatty foods: Rich, greasy foods often cause discomfort for those with IBS.
Caffeine and alcohol: These can irritate the digestive system and increase symptoms like diarrhea or bloating.

By tracking your food intake and symptoms, you can start to identify which foods are causing flare-ups and work toward a personalized plan.

What Causes Constant Constipation in IBS?

Constant constipation in IBS can be caused by:

Low fiber intake
Dehydration: Not drinking enough water can make stool hard and difficult to pass.
Stress: Emotional stress often affects digestion and can contribute to constipation.

If constipation persists despite lifestyle changes, consider speaking with a healthcare provider for further assessment and potential treatment options.

How to Deal with Severe Bloating in IBS?

Severe bloating can occur when:

Gas is trapped in the intestines due to difficulty digesting certain foods or fermentation.
Slow motility: In IBS, the digestive system may move food too slowly, leading to bloating.

To manage bloating, consider reducing high FODMAP foods and incorporating more digestive-friendly meals. Stress management techniques like yoga or mindfulness can also help reduce bloating by calming the nervous system.

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