title: Extending our knowledge of fermentable, short-chain carbohydrates for managing gastrointestinal symptoms.
abstract: The Monash University low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is now accepted as an effective strategy for managing symptoms of irritable bowel syndrome (IBS) in Australia, with interest expanding across the world. These poorly absorbed, short-chain carbohydrates have been shown to induce IBS symptoms of diarrhea, bloating, abdominal pain, and flatus due to their poor absorption, osmotic activity, and rapid fermentation. Four clinical trials have been published to date, all with significant symptomatic response to the low FODMAP diet. Up to 86% of patients with IBS have achieved relief of overall gastrointestinal symptoms and, more specifically, bloating, flatus, abdominal pain, and altered bowel habit from the approach. This review provides an overview of the low FODMAP diet and summarizes the research to date, emerging concepts, and limitations. FODMAPs are known to be beneficial to bowel health; the importance of this and how this should be considered in the clinical management of IBS is also discussed. A clinical management flowchart is provided to assist nutrition professionals in the use of this approach.
authors.affiliation: Monash University, Central Clinical School, Melbourne, 3000 Australia. jacqueline.barrett@monash.edu
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Barrett
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy; D001315:Australia; D003967:Diarrhea / Q000178:diet therapy; D004032:Diet; D050528:Diet, Carbohydrate-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage*; D004187:Disaccharides / Q000009:adverse effects; D005247:Feeding Behavior; D005285:Fermentation; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000178:diet therapy*; D009005:Monosaccharides / Q000009:adverse effects; D009844:Oligosaccharides / Q000009:adverse effects; D011108:Polymers / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic
chemical_list: D004043:Dietary Fiber; D004187:Disaccharides; D009005:Monosaccharides; D009844:Oligosaccharides; D011108:Polymers; C024617:polyol
keywords: FODMAP; abdominal pain; carbohydrates; diarrhea; diet therapy; gastrointestinal diseases; irritable bowel syndrome