IBS & low-FODMAP program · Chandler & Mesa, AZ
The low-FODMAP diet was never meant to be permanent
Most people who try it alone get stuck in the elimination phase. Months later they're eating twelve foods, still symptomatic, and scared of the rest. That's not how the protocol works — and it's the most common reason it fails.
Three phases, not one
The goal is the widest diet you can eat without symptoms. Restriction is the tool, not the destination.
Eliminate
Remove high-FODMAP foods to establish a symptom baseline. Short by design. If nothing improves here, the diet isn't your answer and we look elsewhere.
Reintroduce
Test each FODMAP group one at a time, in measured amounts, with time between. This is the phase almost everyone skips, and it's where the actual answers come from.
Personalize
Build the least restrictive diet that keeps you comfortable. Most people tolerate far more than the elimination phase suggests.
Nearly everyone who arrives having tried this alone stopped after phase one. They got relief, got scared to reintroduce anything, and stayed there. Six months later the list of safe foods has shrunk again.
What FODMAPs are
Five groups of carbohydrates your gut struggles to absorb
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. In plain terms: short-chain carbohydrates that pull water into the intestine and get fermented by gut bacteria, producing gas.
In most people this causes nothing. In people with IBS, whose intestines are more sensitive to stretch and pressure, it causes pain, bloating, and urgency.
- Fructans — wheat, rye, onion, garlic
- Galacto-oligosaccharides — beans, lentils, chickpeas
- Lactose — milk, soft cheese, yogurt
- Excess fructose — apples, mango, honey, high-fructose corn syrup
- Polyols — stone fruit, mushrooms, sorbitol and mannitol in sugar-free gum
Almost nobody reacts to all five. That's the entire point of phase two — finding your two or three instead of avoiding all of them forever.
Before you start
Get tested for celiac disease first
Low-FODMAP eating cuts your wheat intake substantially. Celiac blood tests only work if you're actively eating gluten — start the diet first and the results come back falsely negative.
People who go low-FODMAP on their own routinely lose the ability to be tested accurately, then spend years unsure whether they have celiac disease. Testing takes one blood draw. Do it before you change anything.
The program
What supervision actually adds
The diet is public. Apps and food lists are free. What isn't free is someone making sure it works and ends.
Confirm it's IBS
Celiac disease, inflammatory bowel disease, bile acid malabsorption, and bacterial overgrowth all mimic IBS. Dr. Sharma rules those out before we change your diet.
Structured reintroduction
Each FODMAP group tested separately, in measured doses, with washout days between. Done properly it produces a list of your specific triggers and your tolerance level for each.
Nutritional adequacy
Elimination cuts major fiber and calcium sources. Your dietitian tracks intake so phase one doesn't create a deficiency while it's solving the bloating.
A defined endpoint
The program has a finish line. You leave with a personalized diet, not an open-ended restriction and a list of foods you're afraid of.
If the diet doesn't work
A failed low-FODMAP trial is information, not a dead end
Roughly a quarter to a third of people don't respond. That result is useful — it points away from FODMAP sensitivity and toward something else.
Bacterial overgrowth is a common answer, and it has its own test and its own treatment. Bile acid malabsorption, pelvic floor dysfunction, and gut-brain axis involvement are others. Non-response means we keep looking, not that you try harder.
Your team
A gastroenterologist and a registered dietitian, not one or the other
Most GI practices in the East Valley don't have a dietitian on staff. Most nutrition practices don't have a gastroenterologist who can order a colonoscopy when something doesn't add up.
At Mirage Health you get both. Board-certified gastroenterologist Rajiv Sharma, MD, handles diagnosis, testing, and medication. Our registered dietitians run the program day to day — meal planning, reintroduction scheduling, and the practical work of eating out, traveling, and cooking for a family while you're mid-protocol.
Visits are available in person in Chandler or Mesa, or by video. Most of the dietitian sessions work fine over video.
What to expect
Your first visit
You'll go through your symptom history with Dr. Sharma — when it started, what makes it worse, what you've already cut out, what previous doctors told you. He'll examine you and order whatever testing is needed to confirm IBS rather than assume it.
Once that's clear, you'll meet with a dietitian to plan phase one around what you actually eat. Bring a few days of what you've been eating, including the things you suspect. Bring the list of foods you've already eliminated — that list often tells us more than the symptoms do.
Where to find us
Two offices, the whole East Valley
Chandler
2201 W. Fairview Street, Suite 5
Chandler, AZ 85224
Just off the 101 at Chandler Blvd
Mesa
Viva Med Suites
1910 S. Stapley Dr, Suite 120
Mesa, AZ 85204 · near the 60
Dietitian visits are available anywhere in Arizona by video. Reintroduction check-ins, meal planning, and troubleshooting all work well remotely.
Cost
You'll know the price before you start
We accept most major insurance plans. Dietitian visits are covered under many plans, though coverage for nutrition counseling varies more than it does for physician visits — we'll check your benefits before your first session.
For patients paying out of pocket, we post cash prices upfront. CareCredit financing is available.
Questions
What people ask before booking
How long does the whole program take?
Elimination runs two to six weeks. Reintroduction runs six to eight weeks. So most people are through the structured portion in about three months, then move into a personalized diet they maintain on their own with occasional check-ins.
Can I just use the app and do it myself?
You can, and some people do fine. The two places self-directed attempts break down are reintroduction — which almost nobody completes — and diagnosis, where an undetected celiac or bacterial overgrowth means the diet was never going to be the answer. If you've already tried it alone and stalled, that's the most common reason people come to us.
Do I have to give up gluten forever?
Almost certainly not. The FODMAP in wheat is fructans, not gluten. Most people with IBS tolerate a meaningful amount of wheat once reintroduction establishes their threshold. That's a different situation from celiac disease, which is why we test for it first.
Is the low-FODMAP diet safe long term?
The elimination phase isn't meant to be. It reduces fiber and fermentable substrate that your gut bacteria depend on, and it cuts common calcium and whole-grain sources. That's precisely why the protocol has a reintroduction phase and why staying in phase one indefinitely is the outcome we're trying to prevent.
What if the diet doesn't help?
Then we look elsewhere. A meaningful share of people with IBS symptoms don't respond, and that result narrows the search. Bacterial overgrowth, bile acid malabsorption, and pelvic floor dysfunction are all treatable and all get missed when the diet is the only thing tried.
Does insurance cover the dietitian visits?
Many plans cover medical nutrition therapy, but coverage varies more than it does for physician visits. We'll verify your benefits before your first session, and cash pricing is available if it isn't covered.
Do I need a referral?
Most PPO plans let you book directly with a specialist. Some HMO and Medicare Advantage plans require a referral from your primary care provider. Call us and we'll check your plan before you come in.
Stuck on a diet that keeps getting smaller?
Book online or call 480-210-3155.