The dietitian felt the reduction of the free fructose and the increase in fibre had improved the stool output but in doing this Max was probably eating more fructans . He would now eat high fibre crackers and breads as snacks instead of the excess fruit inbetween meals. This would indeed trigger abdominal pain in a visceral sensitive gut. Worse so during the week when his anxiety increases.
It was decided to do a gentle low FODMAP elimination and return after 4 weeks to guage its effect.
Max responded very well after 2 weeks on the gentle Low FODMAP elimination diet . The dietitian initiated the challenges after 4 weeks with the following results: