Low-FODMAPs diet for irritable bowel syndrome.
Subject: Diet (Health aspects)
Irritable bowel syndrome (Care and treatment)
Author: Gaby, Alan R.
Pub Date: 08/01/2012
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: August-Sept, 2012 Source Issue: 349-350
Product: Product Code: 8000141 Nutrition & Diet Programs NAICS Code: 621498 All Other Outpatient Care Centers
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 303012890
Full Text: Eighty-two patients (mean age, 38 years) with irritable bowel syndrome (IBS) were studied. Prior to June 2009, 39 patients were given standard dietary advice (control group), which included regular meal pattern; limiting insoluble fiber intake for diarrhea and increasing it for constipation; reducing alcohol and caffeine intake; limiting fruit to 3 portions a day; avoiding resistant starch (e.g., pulses, sweet corn, green bananas); limiting sorbitol intake; and, in selected cases, avoiding lactose, doing an elimination diet, and/or using probiotics. From June 2009 onward, 43 patients were given a diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). This diet restricted foods high in fructans (e.g., wheat, onion, garlic), galactooligosaccharides (e.g., chickpeas, lentils), and sorbitol and other polyols; and, in patients with lactose or fructose malabsorption, restricted foods high in lactose and fructose, respectively. After an unspecified period of time, significantly more patients in the low-FODMAPs group than in the control group reported satisfaction with their symptom response (76% vs. 54%; p<0.04) and improvements in bloating (82% vs. 49%; p=0.002), abdominal pain (85% vs. 61%; p=0.023), and flatulence (87% vs. 50%; p=0.001). Among 10 patients who were asked, mean and median times to improvement were 3.5 and 2 weeks, respectively (range, 2-8 weeks).

Comment: Numerous studies have shown that food allergy and intolerance to specific food components (such as lactose, fructose, and sorbitol) can provoke gastrointestinal symptoms in people with IBS. The results of the present study indicate that other food components can also contribute to the symptomatology. Information on how to follow a low-FODMAPs diet is available at www.myfoodmyhealth.com/FODMAP/index.php.

Staudacher HM et al. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diett. 2011;24487-495.

by Alan R. Gaby, MD

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