A Low-FODMAP Diet for Irritable Bowel Syndrome: Some Answers to the Doubts from a Long-Term Follow-Up

Bellini, Massimo; Tonarelli, Sara; Barracca, Federico; Morganti, Riccardo; Pancetti, Andrea; Bertani, Lorenzo; Bortoli, Nicola de; Costa, Francesco; Mosca, Marta; Marchi, Santino; Rossi, Alessandra

doi:10.3390/nu12082360

Cited by 39 publications

(73 citation statements)

References 50 publications

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“…Moreover, the long-term effect of re-challenge on the microbiota is not known. Several studies have raised nutritional concerns about the restrictive phase of the low-FODMAP diet, demonstrating that the reductions in calcium and fibers and long-term effects of this deficiencies are not known [ 212 , 232 , 234 , 235 , 236 ]. In addition, the compliance of patients with the low-FODMAP diet should be further investigated, although the dietitian seems to play a fundamental role [ 237 ].…”

Section: Non-immunologic Adverse Reactions To Foodmentioning

confidence: 99%

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

et al. 2021

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Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management.

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Section: Non-immunologic Adverse Reactions To Foodmentioning

confidence: 99%

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

et al. 2021

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“…Few studies have dealt with this phase of the treatment but a recent report showed that approximately 50% of patients were successful in achieving symptom relief. This study showed the importance of a dietician because many of the initial perceived intolerances were not confirmed during systematic reintroduction [ 95 ].…”

Section: Low Fodmap Dietmentioning

confidence: 99%

Impact of Diet on Symptoms of the Irritable Bowel Syndrome

Spiller

2021

Nutrients

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Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquerade as IBS and may need specialist treatment. While typical food allergy is readily distinguished from IBS, the mechanisms of gut-specific adverse reactions to food are only just being defined. These may include gut-specific mast cell activation as well as non-specific activation by stressors and certain foods. Visceral hypersensitivity, in some cases mediated by mast cell activation, plays a key part in making otherwise innocuous gut stimuli painful. Rapidly fermented poorly absorbed carbohydrates produce gaseous distension as well as short-chain fatty acids and lowering of colonic pH which may cause symptoms in IBS patients. Limiting intake of these in low FODMAP and related diets has proven popular and apparently successful in many patients. Existing diet, colonic microbiota and their metabolic products may be helpful in predicting who will respond. Wheat intolerance may reflect the fact that wheat is often a major source of dietary FODMAPs. It may also be either a forme fruste of coeliac disease or non-specific immune activation. Wheat exclusion can be successful in some of these patients. More research is needed to fully understand the mechanisms of food intolerances and how to best ameliorate them in a personalised medicine approach to diet in IBS.

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“…Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is probably the most popular diet in functional gastrointestinal disorders, where it appears to be effective even in the long-term [ 112 ]. Some authors investigated its role even in the IBD setting.…”

Section: Nutritional Suggestions In Outpatient Managementmentioning

confidence: 99%

Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?

et al. 2021

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Nutrition has an important impact on inflammatory bowel diseases (IBD). In particular, several studies have addressed its role in their pathogenesis, showing how the incidence of IBD significantly increased in recent years. Meanwhile, nutrition should be considered a component of the treatment of the disease, both as a therapy itself, and especially in the perspective of correcting the various nutritional deficiencies shown by these patients. In this perspective, nutritional suggestions are very important even in the most severe forms of IBD, requiring hospitalization or surgical treatment. Although current knowledge about nutrition in IBD is increasing over time, nutritional suggestions are often underestimated by clinicians. This narrative review is an update summary of current knowledge on nutritional suggestions in IBD, in order to address the impact of nutrition on pathogenesis, micro- and macro-nutrients deficiencies (especially in the case of sarcopenia and obesity), as well as in hospitalized patients.

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A Low-FODMAP Diet for Irritable Bowel Syndrome: Some Answers to the Doubts from a Long-Term Follow-Up

Cited by 39 publications

References 50 publications

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

Impact of Diet on Symptoms of the Irritable Bowel Syndrome

Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?

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