For those the LowFODMAP diet didn't work for , I think this about Histamines is really interesting (I've not read about this before). Interestingly many of the high Histamine foods mentioned are low-FODMAP foods.
(from article linked to above)
HISTAMINE & IBS
We have discussed that not all foods raise a measurable immune (immunoglobulin)
mediated reaction potentially resulting in a negative food allergy/ intolerance
test but with IBS symptoms still predominant. For IBS symptoms that do not
resolve with other dietary approaches like removing gluten, dairy and low
FODMAPs foods, it may be useful to consider the levels of dietary histamine.
Histamine acts as an important signalling messenger throughout the body
including the brain and gut. Our body synthesises and stores histamine in mast
cells, especially in the gastrointestinal tract. High levels of histamine are also
present in certain foods (Table 2). A healthy gut and immune system regulates
histamine levels via the enzyme diamine oxidase (DAO), found in high levels
in the gut mucosa. However, intestinal permeability and dysbiosis can reduce
DAO activity and, coupled to high levels of histamine in the diet, may cause
and/or exacerbate IBS symptoms including bloating, cramping and diarrhoea.
For people who are still experiencing IBS symptoms after some dietary changes,
reducing the dietary histamine load for a few weeks during the 5R programme
and supplementing with DAO enzyme may be beneficial (Table 2).
Fermented foods, which have long been associated with naturopathic diets
for increasing levels of beneficial bacteria, are also rich in biogenic amines
that reduce the activity of DAO.43A This means that in the early stages of
an IBS programme, using high scientifically proven probiotic supplements,
alongside dietary approaches to support the levels of beneficial gut bacteria
(see REINOCULATE stage) may manage IBS symptoms better and prevent IBS
flare ups. Fermented foods can be introduced later in the IBS programme and
enjoyed long term when gut structure and function is more efficient.
TABLE 2. HISTAMINE IN THE DIET
High Histamine Foods or
Foods That Release Histamine (HR foods)
Alcohol - champagne, wine, beer, cider and other fermented drinks and spirits
Pickled or canned foods - e.g. sauerkraut
Matured cheeses - e.g. parmesan, mature cheddar
Mushrooms and Quorn
Smoked meat products - salami, ham, sausages, bacon
Fish - tinned and smoked fish and shellfish
Beans and pulses - chickpeas, soy beans, peanuts
Dried fruit, seeds and nuts
Chocolates and other cocoa based products
Vinegar including salad dressings, pickles, mayonnaise, ketchup, mustard
Ready meals
Yeast extract, yeast
Additives - benzoate, sulphites, nitrites, glutamate, food dyes
FruitHR - bananas, strawberries, tomatoes, pineapple, mango, raspberry,
grapefruit, avocado, tangerines
VegetablesHR - spinach, pumpkin, aubergines
Green and black tea (block DAO enzyme)
Low Histamine Foods
Fresh meat (cooled, frozen or fresh) including chicken
Freshly caught fish
Egg yolk
Fresh fruits - with the exception of strawberries, and other fruits listed on the
HR column, most fresh fruits are considered to have a low histamine level
Fresh vegetables - with the exception of tomatoes, pumpkin and aubergine
most fresh vegetables are considered to have a low histamine level
Grains - short grain brown rice, rice noodles, yeast free rye bread, rice crisp
bread, oats, puffed rice crackers, millet flour, pasta (spelt and corn based)
Dairy alternatives - coconut milk, rice milk, oat milk
Cooking oils - especially organic virgin coconut oil
Organic flaxseed oil
Leafy herbs
Herbal teas - including peppermint, ginger or fennel