FODMAPs and Irritable Bowel: Finally Evidence
A simple diet low in FODMAPS could improve the lives of many people with a common digestive disorder but without treatment, irritable bowel syndrome.
FODMAPs (for Fermentescibles, Disaccharides Monosaccharides and Polyols ) are short-chain carbohydrates that are little absorbed by the small intestine, they are then fermented in gas in the colon, causing the belly to swell. They are present in certain plants rich in prebiotics (fibers) such as onion, artichoke, cabbage or wheat. Wheat contains gluten but also FODMAPs, which is why some people see their symptoms improve by not eating wheat (2). They would then wrongly think that gluten is the cause of the symptoms.
In this new study, researchers from the University of Michigan separated 90 people suffering from irritable bowel syndrome in 2 groups for 6 weeks:
– A group with a diet limiting irritants like coffee, alcohol, hearty meals, called “common sense” group.
– A group following a diet low in FODMAPs.
Irritable bowel syndrome (also called functional intestinal disorders, or functional colopathy) is a frequent chronic disease (10% of the population would be affected) that is not severe but greatly impairs quality of life. People suffer from diarrhea and constipation, with recurrent abdominal pain (intestinal cramps, bloating and / or flatulence).Treatments are based on drugs that are often costly and which, in addition to being ineffective, have troublesome side effects.
RESULTS: Of the “common sense” group, 20% of patients had an improvement of 50% in the FODMAPs group. In addition, the diet low in FODMAPs decreased the annoying symptoms in 61% of participants compared with 27% in the “common sense” group such as bloating, diarrhea or urgent desire to go to the toilet.
This study is “the only methodically rigorous clinical study that shows that a diet low in FODMAPs not only improves the symptoms but also the quality of life of patients suffering from irritable bowel syndrome,” according to Dr. Shanti Eswaran, who coordinated ‘study.
The results echo a meta-analysis of clinical trials (of lower quality) that reported a beneficial effect of the diet without FODMAPs (3).
Now that it is established that the low-FODMAP diet is effective in a large number of patients, researchers expect to determine why certain foods cause reactions in some but not others.
(1) Shanti L. Eswaran, William D. Chey, Kenya Jackson, Sivaram G. Pillai, Samuel W. Chey, Theresa Han-Markey. “A Low FODMAP Diet Improves Quality of Life, Reduces Activity Impairment, and Improves Sleep Quality in Patients With Irritable Bowel Syndrome and Diarrhea: Results From a U.S. Randomized, Controlled Trial”. Gastro Journal, Mai 2015. doi: http://dx.doi.org/10.1016/S0016-5085(16)30665-5.
(2) El-Salhy M Hatlebakk JG, Gilja OH, Hausken T. “The relation between celiac disease, nonceliac gluten sensitivity and irritable bowel syndrome.” Nutr J. 2015 Sep 7;14:92. doi: 10.1186/s12937-015-0080-6.
(3) Maagaard L, Ankersen DV, Végh Z, Burisch J, Jensen L, Pedersen N, Munkholm P. “Follow-up of patients with functional bowel symptoms treated with a low FODMAP diet.” World J Gastroenterol. 2016 Apr 21;22(15):4009-19. doi: 10.3748/wjg.v22.i15.4009.