Low FODMAPs diet for functional abdominal pain disorders in children: critical review of current knowledge

• Published in: Jornal de pediatria 2019-11, Vol.95 (6), p.642-656
• Main Authors: Pensabene, Licia, Salvatore, Silvia, Turco, Rossella, Tarsitano, Flora, Concolino, Daniela, Baldassarre, Maria Elisabetta, Borrelli, Osvaldo, Thapar, Nikhil, Vandenplas, Yvan, Staiano, Annamaria, Saps, Miguel
• Format: Article
• Language: English
• Subjects: Abdominal Pain - diet therapy; Children; Crianças; Diet; Diet, Carbohydrate-Restricted; Dieta de polióis; Disaccharides; Disaccharides - metabolism; Disaccharides - therapeutic use; Dissacarídeos; Distúrbios de dor abdominal funcional; Fermentable oligosaccharides; Functional abdominal pain disorders; Humans; Irritable Bowel Syndrome; Monosaccharides; Monosaccharides - metabolism; Monosaccharides - therapeutic use; Monossacarídeos; Oligosaccharides - metabolism; Oligosaccharides - therapeutic use; Oligossacarídeos fermentáveis; PEDIATRICS; Polyol diet
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2019.03.004

This narrative review aimed to provide practitioners a synthesis of the current knowledge on the role of a low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet in reducing symptoms associated with functional abdominal pain disorders in children. This review is focused on the pathophysiology, efficacy and criticism of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet in children. Cochrane Database, Pubmed and Embase were searched using specific terms for Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet interventions and functional abdominal pain disorders. In children, only one Randomized Control Trial and one open-label study reported positive results of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols diet; one Randomized Control Trial showed exacerbation of symptoms with fructans in children with Irritable Bowel Syndrome; no effect was found for the lactose-free diet whilst fructose-restricted diets were effective in 5/6 studies. In children there are few trials evaluating low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols in functional abdominal pain disorders, with encouraging data on the therapeutic efficacy particularly of fructose-restricted diet. Additional efforts are still needed to fill this research gap and clarify the most efficient way for tailoring dietary restrictions based on the patient's tolerance and/or identification of potential biomarkers of low Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols efficacy, to maintain nutritional adequacy and to simplify the adherence to diet by labeling Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols content in commercial products. Nos últimos anos, foram feitos esforços consideráveis para esclarecer o papel da dieta com baixo teor de oligossacarídeos fermentáveis, dissacarídeos, monossacarídeos e polióis (FODMAPs) para o tratamento de distúrbios gastrintestinais funcionais (DGIFs). Esta revisão narrativa teve como objetivo fornecer aos profissionais uma síntese do conhecimento atual sobre o papel de uma dieta com baixo teor de FODMAPs (BFM) na redução dos sintomas associados a distúrbios funcionais de dor abdominal (DFDA) em crianças. Esta revisão está focada na fisiopatologia, eficácia e crítica da dieta BFM em crianças. O banco de dados Cochrane, Pubmed e Embase foram pesquisados com o uso dos termos específicos para interv