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Fructans allergy got you beet? I've got your back. Literally

As osteopaths we do a lot more than treat musculoskeletal pain - we guide the body through inflammation and torsions, we try to strike the balance of health. This is challenging with a lot more going on behind the scenes than just a massage and adjustment. Here’s an insight into why...
If we look at the body in a segmented, incongruous way we are starving ourselves of the most important thing. That being that we are indeed a unit. We are a dynamically shifting and constantly developing unit that is searching for homeostasis and balance. We are a bubble floating in a 3D sphere, where inputs are coming in from every direction, pushing and pulling and changing the environment within our little sphere. All that our little bubble wants is to float calmly in the centre, balanced with the right amount of inputs and outputs.

We talk mainly of the physical inputs. Think posture, exercise, stretching etc. But what of the other inputs? What about dietary intolerances? The media was alive with the talk of a cure for coeliac
disease in the form of a vaccine, which would improve the lives of millions worldwide. From an osteopathic perspective, this is more than being able to sit down to enjoy a thick slab of sourdough or a creamy wheat beer (although that is important too). It means that these people, if able to break down gluten, will avoid high levels of inflammation in their daily lives. So what does that mean to your physical presentation, such as how does inflammation from dietary intolerances can drive back pain?

To answer that question we need to understand what inflammation is? Inflammation is the natural way our body begins the healing process, it is a necessary part of living! Inflammation has copped a pretty bad wrap from mainstream click-bait media over the years and continues to be misunderstood, even by health professionals. In a normal healthy body, inflammation kicks off the immune response (white blood cells and immune cells) designed to clean up damaged tissue in a self-regulated and automatic response. Sometimes, however, when the immune response doesn’t get it right and inflammation doesn’t self regulate, it ends up feeding into its self and causing ongoing chronic inflammation - this is the bad inflammation. This can happen due to a number of reasons, but today we will be looking from a dietary cause.

Fructans are chains of fructose sugars joined together with glucose at the end. They are part of the oligo component of the FODMAP diet. In order to absorb the fructans, the body must break down the complex sugar into single sugars (monosaccharides). However, the human body doesn’t possess the enzyme required to break down the sugars. Instead, they pass through the gastrointestinal tract (GIT) unprocessed and begin to ferment in the intestine once they meet normal bacteria that are present in the GIT (1). This fermentation causes mild gas and wind in a normal GIT. However those with hypersensitive GIT’s suffering from IBS this causes bloating, discomfort and altered motility as well as diarrhoea and vomiting. This can be avoided by avoiding things such as the flesh from onions, apples, and garlic.

The information behind the pathogenesis (cause and origin) of IBS is conflicting. However what is agreed upon is the link between the bacteria (flora) of the gut, micro-inflammation, genetics
and diet (2). Inflammation in the viscera (organs) including the GIT can drive back pain through what is known as a viscera-somatic reflex where inflammation of the viscera/gut drives pain in the musculoskeletal system. While IBS will unlikely cause major back pain, it is a contributing factor that shifts our bubble within the sphere and contributes to the individual's total balance of health and via the disruption of homeostasis. Osteopathy can help reduce constipation and restriction of the fascial system of the GIT, improving motility and bind. This is a common presentation that osteopaths see every week. It is best when paired with adjusting the individual's diet and compounding factors.
So when you’re next in pain and the normal remedies just aren’t helping, ask yourself how is your gut going and pop in to see your friendly osteopath.

(1) What are the oligos (fructans & GOS)? What are the oligos (fructans & GOS)?. (2016). Monashfodmap.com. Retrieved 18 December 2018, from https:// www.monashfodmap.com/blog/what-are-oligos/

(2) Sinagra, E., Pompei, G., Tomasello, G., Cappello, F., Morreale, G. C., Amvrosiadis, G., Rossi, F., Monte, A. I. L., Rizzo, A. G., and Raimondo, D. Sinagra, E., Pompei, G., Tomasello, G., Cappello, F., Morreale, G., & Amvrosiadis, G. et al. (2016). Inflammation in irritable bowel syndrome: Myth or new treatment target?. World Journal Of Gastroenterology, 22(7), 2242-2255. doi:10.3748/wjg.v22.i7.2242

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