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Feature Article

Functional bowel disorders and FODMAPs

Emma Halmos, Jane G Muir, Sue Shepherd, Peter R Gibson

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Abstract

A diet that is low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) has been shown to be effective in reducing gastrointestinal symptoms in patients with functional gut disorders.

Key Points

  • Functional bowel disorders (including irritable bowel syndrome) affect up to 12% of the population.
  • There is increasing evidence for the efficacy of the low FODMAP diet in the management of functional bowel disorders.
  • Breath hydrogen testing for fructose and lactose malabsorptions may help to tailor the low FODMAP diet to the individual patient.
  • A negative result for breath testing does not exclude the diagnosis of functional bowel disorder or the use of the low FODMAP diet as restriction of the other FODMAPs may still be therapeutic.
  • Liberalisation of the diet after symptom control has been achieved is possible in most patients.
  • Dietary restriction through the guidance of a dietitian is recommended for patients with functional bowel disorders.

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