Choosing a strict gluten-free diet when you only require a low FODMAP diet can lead to over-restriction. For example, oats and spelt bread contain gluten but are relatively low in FODMAPs so are suitable to have on a low FODMAP diet in appropriate servings. In addition, gluten is found in products derived from wheat, rye and barley, such as wheat starch, wheat thickeners and barley malt. These are common ingredients in a wide range of commercial products including soy sauce, confectionary, mayonnaise, yoghurts and more. They contain gluten and must be avoided on a gluten free diet for coeliac disease, but they are not high in fructans and are suitable to include in a low FODMAP diet.
So, for the 15-20% who relapse you go on antibiotics for 10-14 days again, or you may find physicians using the tapering method. This is where your physician might ask you to go on antibiotics for a week or so, and slowly taper down the strength or amount of antibiotics over a month or so. You may also be asked to try a pulsing method which is similar except you might take antibiotics every other day while tapering down to lower levels of antibiotics. So, these methods will vary in time, so let’s assume it takes another 30 days. Now we’re up to what, 45 days?