Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date

This review summarizes the published clinical studies concerning the management of irritable bowel syndrome (IBS) using restriction of Fermentable Oligosaccharide, Disaccharide, Monosaccharide, and Polyols in the diet (low FODMAP diet). In recent years, the data supporting low FODMAP diet for the ma...

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Bibliographic Details
Published in:Clinical and experimental gastroenterology 2016-01, Vol.9 (Issue 1), p.131-142
Main Authors: Nanayakkara, Wathsala S, Skidmore, Paula Ml, O'Brien, Leigh, Wilkinson, Tim J, Gearry, Richard B
Format: Article
Language:English
Subjects:
Abdomen
Alcohol
Carbohydrates
Citrus
Clinical trials
Constipation
Dairy products
Diet
Food
Fructose
Gastroenterology
gastrointestinal symptoms
Hypnotherapy
Inflammatory bowel disease
Irritable bowel syndrome
Lactose
low FODMAP diet
Medical research
Microbiota
Nutrition research
Pain
Polyols
Retirement benefits
Review
Studies
Systematic review
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Summary:This review summarizes the published clinical studies concerning the management of irritable bowel syndrome (IBS) using restriction of Fermentable Oligosaccharide, Disaccharide, Monosaccharide, and Polyols in the diet (low FODMAP diet). In recent years, the data supporting low FODMAP diet for the management of IBS symptoms have emerged, including several randomized controlled trials, case-control studies, and other observational studies. Unlike most dietary manipulations tried in the past to alleviate gastrointestinal symptoms of IBS, all studies on low FODMAP diet have consistently shown symptomatic benefits in the majority of patients with IBS. However, dietary adherence by the patients and clear dietary intervention led by specialized dietitians appear to be vital for the success of the diet. Up to 86% of patients with IBS find improvement in overall gastrointestinal symptoms as well as individual symptoms such as abdominal pain, bloating, constipation, diarrhea, abdominal distention, and flatulence following the diet. FODMAP restriction reduces the osmotic load and gas production in the distal small bowel and the proximal colon, providing symptomatic relief in patients with IBS. Long-term health effects of a low FODMAP diet are not known; however, stringent FODMAP restriction is not recommended owing to risks of inadequate nutrient intake and potential adverse effects from altered gut microbiota. In conclusion, the evidence to date strongly supports the efficacy of a low FODMAP diet in the treatment of IBS. Further studies are required to understand any potential adverse effects of long-term restriction of FODMAPs.
ISSN:1178-7023
1178-7023
DOI:10.2147/CEG.S86798