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The Efficacy of a Diet Low in Fermentable Sugars in the Reduction of Symptoms for Patients with Irritable Bowel Syndrome

10 August 2013


Background: Irritable bowel syndrome (IBS) is a common disorder, affecting 7-10% of the worldwide population. It consists of abdominal pain and altered bowel habits present for at least three months. Poorly absorbed, short-chain carbohydrates are grouped based on chain length and result in the acronym FODMAP: fermentable oligo-, di-, mono-, and polyols. These FODMAPs pass through the small bowel unabsorbed and may be affecting symptoms in those with IBS. Does a diet low in fermentable sugars improve symptoms for patients with IBS?

Method: An exhaustive literature search was conducted using Medline, CINAHL, and Google Scholar with use of keywords “FODMAP diet” and “irritable bowel syndrome.” Further review of bibliographies was completed for any other relevant resources. Articles were then assessed for quality using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results: After reviewing for relevancy, three articles met inclusion criteria. These articles included three randomized control trials. A double-blinded, randomized, placebo-controlled trial with 26 participants demonstrated reduction in symptom severity with a diet low in FODMAPs. A randomized control trial with 41 participants successfully established a reduced symptom profile in patients with IBS when adhering to a diet low in FODMAPs. Lastly, a randomized, single-blinded control trial recruited both healthy patients and those with IBS to demonstrate the success of a low FODMAP diet.

Conclusion: A diet low in fermentable sugars has demonstrated reduction of symptoms in patients with irritable bowel syndrome. Primary care providers as well as GI specialists can educate their patients with IBS on the diet and encourage them to adhere with little worry of cost or harm to the population. Although the studies have limitations and further, stronger research is needed, the benefits of this lifestyle intervention seem to outweigh the risks to the patient.


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