Diet as a therapeutic tool in chronic gastrointestinal disorders: Lessons from the FODMAP journey

Gibson, Peter R; Halmos, Emma P; So, Daniel; Yao, Chu K; Varney, Jane; Muir, Jane G.

doi:10.1111/jgh.15772

Cited by 18 publications

(19 citation statements)

References 77 publications

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“…intake of energy, fiber, and calcium). [6][7][8][9] Psychological issues such as disordered eating or eating disorders and social isolation may also arise. 7,10 Therefore, a low-FODMAP diet needs to be provided under dietetic and psychological supervision.…”

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confidence: 99%

“…[6][7][8][9] Psychological issues such as disordered eating or eating disorders and social isolation may also arise. 7,10 Therefore, a low-FODMAP diet needs to be provided under dietetic and psychological supervision. 6,7 Candidates for such dietary intervention should be carefully considered.…”

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confidence: 99%

“…7,10 Therefore, a low-FODMAP diet needs to be provided under dietetic and psychological supervision. 6,7 Candidates for such dietary intervention should be carefully considered. In some patients, such as those with undernutrition or eating disorders, other therapeutic approaches or a less restrictive low-FODMAP diet type (i.e., "FODMAPgentle diet") may be more appropriate.…”

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confidence: 99%

“…If used in children, nutritional adequacy, growth, and psychosocial development should be carefully monitored. 7,11 Five previous systematic reviews (in children, or children and adults) 2,[12][13][14][15] found limited evidence with regard to use of a low-FODMAP diet in children with FAPD. However, two new trials 16,17 were recently published.…”

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confidence: 99%

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FODMAP dietary restrictions in the management of children with functional abdominal pain disorders: A systematic review

Stróżyk

Horvath

Szajewska

2022

Neurogastroenterology Motil

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The available nutritional interventions for the management of functional abdominal pain disorders (FAPD) in children are limited. 1,2 Evidence of the efficacy of implementing a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is limited. 2 The rationale for use of a low-FODMAP diet is based on the assumption that a decrease in the short-chain fermentable carbohydrate load, both, prevents the osmotic effect of FODMAPs, resulting in a decrease in small intestine water volume, and limits the exaggerated fermentation of FODMAPs by colonic microbiota and associated gas production, which may alleviate recurrent abdominal pain (RAP). 3 A typical three-step low-FODMAP diet is commonly used in adults with IBS 4 (for a summary of the definitions of a low-FODMAP diet, see Table S1).However, in children with FAPD, a simplified version of the diet, called a "FODMAP-gentle diet" or "bottom-up approach" that excludes only a few foods with high concentrations of FODMAPs and/or a few targeted FODMAPs, also may be used to avoid over-restriction. 5,6 As for all restrictive diets, potential risks need to be considered.The main concerns associated with use of a low-FODMAP diet include alteration of the gut microbiota composition (i.e., decrease in the fecal Bifidobacterium spp.) and dietary inadequacy (including risk of lower

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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FODMAP dietary restrictions in the management of children with functional abdominal pain disorders: A systematic review

Stróżyk

Horvath

Szajewska

2022

Neurogastroenterology Motil

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“…Numerous papers and clinical guidelines now specifically recommend dietitian-led delivery of the FODMAP diet. 65,70,[78][79][80][81] However, in situations where dietitian availability is limited or patients choose a self-guided approach, several considerations may be made depending upon the scenario.…”

Section: How To Deliver the Diet In Areas Where Dietitians Are Not Av...mentioning

confidence: 99%

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Sultan

Varney

Halmos

et al. 2022

J Neurogastroenterol Motil

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Background/AimsThe 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian's perspective. MethodsRecent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus. ResultsThe dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown. ConclusionWhile the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.

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Evolution, adaptation, and new applications of the FODMAP diet

O'Brien,

Kasti,

Halmos

et al. 2024

JGH Open

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The FODMAP diet has been a treatment of irritable bowel syndrome (IBS) for many years. Rigorous scientific evaluation and clinical application of the FODMAP diet have generated deep understanding regarding clinical efficacy, mechanisms of action, and potential adverse effects of this dietary approach. In turn, this knowledge has allowed fine‐tuning of the diet to optimize treatment benefits and minimize risks, in the form of the traditional three‐phase diet; the FODMAP‐gentle approach, which is a less restrictive iteration; and a proposed FODMAP‐modified, Mediterranean‐style diet which endeavours to optimise both gastrointestinal symptoms and other health parameters. Furthermore, recognition that IBS‐like symptoms feature in other conditions has seen the FODMAP diet tested in non‐IBS populations, including in older adults with diarrhea and women with endometriosis. These areas represent new frontiers for the FODMAP diet and a space to watch as future research evaluates the validity of these novel clinical applications.

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Diet as a therapeutic tool in chronic gastrointestinal disorders: Lessons from the FODMAP journey

Cited by 18 publications

References 77 publications

FODMAP dietary restrictions in the management of children with functional abdominal pain disorders: A systematic review

FODMAP dietary restrictions in the management of children with functional abdominal pain disorders: A systematic review

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Evolution, adaptation, and new applications of the FODMAP diet

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