Low-FODMAP Diet for Irritable Bowel Syndrome: What We Know and What We Have Yet to Learn

Annu Rev Med. 2020 Jan 27;71:303-314. doi: 10.1146/annurev-med-050218-013625.

Abstract

Irritable bowel syndrome (IBS) is the most prevalent of gastrointestinal (GI) conditions, affecting millions of people worldwide. Given that most IBS patients associate their GI symptoms with eating food, specific dietary manipulation has become an attractive treatment strategy. A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) has generated the greatest level of scientific and clinical interest. Overall, 52-86% of patients report significant improvement of their IBS symptoms with elimination of dietary FODMAPs. Patients who experience symptom improvement with FODMAP elimination should undergo a structured reintroduction of foods containing individual FODMAPs to determine sensitivities and allow for personalization of the diet plan. This review discusses the literature surrounding the administration of the low-FODMAP diet and its efficacy in the treatment of IBS.

Keywords: FODMAP; IBS; diet; functional; irritable bowel syndrome; nutrition.

Publication types

  • Review

MeSH terms

  • Diet, Carbohydrate-Restricted / methods*
  • Disaccharides
  • Fermentation
  • Fructans / metabolism
  • Fructose / metabolism
  • Gastrointestinal Microbiome
  • Gastrointestinal Motility
  • Glucose / metabolism
  • Humans
  • Intestinal Mucosa / metabolism
  • Irritable Bowel Syndrome / diet therapy*
  • Irritable Bowel Syndrome / metabolism
  • Irritable Bowel Syndrome / microbiology
  • Irritable Bowel Syndrome / physiopathology
  • Lactose / metabolism
  • Monosaccharides
  • Oligosaccharides
  • Permeability
  • Treatment Outcome

Substances

  • Disaccharides
  • Fructans
  • Monosaccharides
  • Oligosaccharides
  • Fructose
  • Glucose
  • Lactose