The role of fermentable carbohydrates and beverages in the symptomatology of functional gastrointestinal disease

Scand J Gastroenterol. 2017 Nov;52(11):1224-1234. doi: 10.1080/00365521.2017.1365931. Epub 2017 Aug 21.


Objectives: The pathophysiology behind functional gastrointestinal disease (FGID) has not been defined, but an intestinal accumulation of fermentable short-chain carbohydrates (FODMAPs) is thought to be involved. A restricted coffee intake is recommended. The aim was to investigate if symptoms of FGID were associated with intake of certain foods (including FODMAPs), as well as beverages (including coffee and tea).

Method and materials: Data were used from participants, age range 45-75 years, who had answered the EpiHealth questionnaire about their background factors, health status and intake of food and beverages. After exclusion of organic bowel diseases, 16,840 participants remained. The impact of food and beverages on functional abdominal pain, functional bloating, functional constipation and functional diarrhea were examined by adjusted binary logistic regression.

Results: Wholemeal bread (Swedish cracker) (OR: 1.361; 95% CI: 1.001-1.851) and white bread (low fiber content) (OR: 1.527; 95% CI: 1.075-2.169) were associated with constipation, whereas soft wholemeal bread (high fiber content) was associated with diarrhea (OR: 1.601; 95% CI: 1.040-2.463). Cheese was associated with bloating (OR: 1.460; 95% CI: 1.004-2.123). A high tea intake was associated with abdominal pain (p for trend =.003), bloating (p for trend = .039) and diarrhea (p for trend <.001), whereas coffee intake was associated with a decreased risk of abdominal pain (p for trend = .002) and bloating (p for trend = .007). High soda intake associated with abdominal pain and bloating and juice with diarrhea.

Conclusion: There are weak associations between intake of grain and dairy products and FGID symptoms. Tea is associated with increased risks, whereas coffee is associated with lower risks, of FGID symptoms.

Keywords: Beverages; FODMAPs; functional gastrointestinal diseases.

Publication types

  • Multicenter Study

MeSH terms

  • Abdominal Pain / etiology
  • Aged
  • Beverages / adverse effects*
  • Constipation / etiology
  • Diarrhea / etiology
  • Dietary Carbohydrates / adverse effects*
  • Dietary Carbohydrates / metabolism
  • Female
  • Fermentation
  • Gastrointestinal Diseases / chemically induced*
  • Gastrointestinal Diseases / physiopathology*
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Sweden


  • Dietary Carbohydrates