In recent years, researchers have taken an interest in identifying dietary strategies for the treatment of gastrointestinal disorders, specifically irritable bowel syndrome. Individuals following elimination protocols to include low-carbohydrate, low-fructose/fructan, and gluten-free diets have had limited suppression of symptoms such as bloating, abdominal pain, constipation, and flatus. Clinicians, including registered dietitian nutritionists armed with only limited efficacy data, lack of patient acceptance, and recognition of potential nutritional deficiencies related to long-term adherence, were reluctant to recommend unproven dietary strategies to their patients. The use of the low-FODMAP diet to design an eating plan, however, has shown symptom improvement in greater than 70% of patients affected with irritable bowel syndrome. Controlled trials have demonstrated the efficacy of this approach in symptom reduction and improvement in quality of life. However, most of the published literature describes short-term trials. Dietary elimination of FODMAP foods is a confusing and difficult task not only for patients but also for healthcare providers. In this article, we present the case of a patient using low FODMAP over a period of 4 years and its impact on quality of life, along with a discussion of elimination diets and the FODMAP approach.