Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia

Abstract

Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients’ quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health‐care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms.

FODMAP meal challenge test: a novel investigation to predict response to low‐FODMAP diet in non‐constipating irritable bowel syndrome

“…13,14 Difficulties in implementing such an overly restrictive diet relate to its availability, cost, social acceptability, psychological consequences, challenges to the caregiver, long-term nutritional consequences, and adverse effects on the gut microbiota. 13,14 Additional difficulties in implementing a low-FODMAP diet occur among vegetarians 15 as many of the vegetarian foods, particularly those with high protein content, are high in FODMAPs. Hence, a test that will predict who would respond and who would not to a low-FODMAP diet is the need of an hour.…”

“…11,12 Implementing a low-FODMAP diet is quite difficult and may cause gut microbiota dysbiosis and nutritional deficiency and incur extra expenditure. 13,14 Additional difficulties in implementing a low-FODMAP diet are experienced by vegetarians, lactose-intolerant populations, and those whose staple cereal is wheat. 15 Considering the above-mentioned factors in addition to the fact that only about half of the IBS patients respond to a low-FODMAP diet, 6 a test predicting response to such a difficult dietary restriction is needed.…”

An Asian perspective on irritable bowel syndrome

“…Moreover, few recent studies have shown that a low FODMAP diet is more effective in Asian patients with IBS compared with conventional Asian foods [ 25 - 27 ]. Usually, traditional Korean food includes white rice and various side dishes containing seasonings and sauces [ 9 , 28 ]. Rice has low fiber content, which is absorbed nearly completely in the small intestine.…”

“…Rice is main source of carbohydrate in Asian people. On the other hand, kimchi is a traditional Korean side dish that contains FODMAP-rich ingredients, such as garlic, napa cabbage, and onion [ 28 ]. Moreover, kimchi is usually served as a side dish with nearly all Korean foods.…”

Interactions of Little-brain and Big-brain in Explaining Abdominal Symptoms

“…As these sugars are readily fermented by the bacteria, the produced gas would stretch the large bowel resulting in symptoms (e.g., bloating), especially in hypersensitive IBS. A low FODMAPs diet has been shown in clinical trials to benefit IBS 9 .…”