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    Can Low-FODMAP Rye Bread Help Us Understand Irritable Bowel Syndrome?


    Jefferson Adams


    • Can rye bread low in FODMAPs reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms, compared to regular rye bread?


    Image Caption: Image: CC--Marco Verch

    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.


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    FODMAPs are Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPS are molecules found in food, and can be poorly absorbed by some people. Poor FODMAP absorption can cause celiac-like symptoms in some people. FODMAPs have recently emerged as possible culprits in both celiac disease and in irritable bowel syndrome.

    In an effort to determine what, if any, irritable bowel symptoms may triggered by FODMAPs, a team of researchers recently set out to compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill.

    A team of researchers compared low-FODMAP rye bread with regular rye bread in patients irritable bowel syndrome, to see if rye bread low FODMAPs would reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms compared to regular rye bread. The research team included Laura Pirkola, Reijo Laatikainen, Jussi Loponen, Sanna-Maria Hongisto, Markku Hillilä, Anu Nuora, Baoru Yang, Kaisa M Linderborg, and Riitta Freese.

    They are variously affiliated with the Clinic of Gastroenterology; the Division of Nutrition, Department of Food and Environmental Sciences; the Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki in Helsinki, Finland; the University of Helsinki and Helsinki University, Hospital Jorvi in Espoo, Finland; with the Food Chemistry and Food Development, Department of Biochemistry, University of Turku inTurku, Finland; and with the Fazer Group/ Fazer Bakeries Ltd in Vantaa, Finland.

    The team wanted to see if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, improved transit times, and fewer IBS symptoms than regular rye bread. 

    To do so, they conducted a randomized, double-blind, controlled cross-over meal study. For that study, seven female IBS patients ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day.

    The team used SmartPill, an indigestible motility capsule, to measure intraluminal pH, transit time, and pressure. Their data showed that low-FODMAP rye bread reduced colonic fermentation compared with regular rye bread. They found no differences in pH, pressure, or transit times between the breads. They also found no difference between the two in terms of conditions in the gastrointestinal tract.

    They did note that the gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only once in 14 measurements, and therefore did not follow on par with the rye bread bolus.

    There's been a great deal of interest in FODMAPs and their potential connection to celiac disease and gluten-intolerance. Stay tuned for more information on the role of FODMAPs in celiac disease and/or irritable bowel syndrome.

    Source:

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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  • Related Articles

    Jefferson Adams
    Celiac.com 02/13/2015 - Food intolerance is non-immunological and is often accompanied by gastrointestinal symptoms. 
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    To do so, Lomer searched Pubmed, Embase and Scopus for the terms and variants of food intolerance, lactose, FODMAP, gluten, food chemicals. He restricted his search to human studies published in English. Lomer also conducted a physical search for references to these terms from relevant papers and appropriate studies.
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    One area researchers now have a bit more solid scientific data about is the role of short-chain fermentable carbohydrates (FODMAPs) in causing gastrointestinal food intolerance. Food exclusion followed by gradual food reintroduction is the best way to diagnose such food intolerance, and to relieve symptoms.
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    This will help to increase dietary variety, ensure nutritional adequacy and minimize impact on the gastrointestinal microbiota.
    Source:
    Alimentary Pharmacology & Therapeutics. Volume 41, Issue 3, pages 262–275, February 2015. DOI: 10.1111/apt.13041 More info on the FODMAP diet from Stanford Univerisity.

    Jefferson Adams
    Celiac.com 06/06/2016 - Irritable Bowel Syndrome (IBS) is one of the most common types of functional bowel disorder. As researchers attempt to unravel the mysteries behind IBS, they have payed increasing attention to the possible impact of food and diet.
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    A research team recently set out to examine the issue, especially with respect to gluten and FODMAP sensitivity. The research team included Roberto De Giorgio, Umberto Volta, and Peter R Gibson. They are variously affiliated with the Department of Medical and Surgical Sciences, Centro di Ricerca Bio-Medica Applicata (C.R.B.A.) and Digestive System, St. Orsola-Malpighi Hospital at the University of Bologna in Bologna, Italy, and the Department of Gastroenterology Alfred Hospital at Monash University in Melbourne, Australia.
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    The role of FODMAPs in eliciting the clinical picture of IBS goes further since these short-chain carbohydrates are found in many other dietary components, including vegetables and fruits.
    In their review, they assessed current literature in order to unravel whether gluten/wheat/FODMAP sensitivity represent 'facts' and not 'fiction' in IBS symptoms.
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    Read more at: Gut. doi:10.1136/gutjnl-2015-309757



    Jefferson Adams
    Celiac.com 12/15/2016 - Celiac disease and irritable bowel syndrome (IBS) can have similar symptoms, and confusion between the two can often cause delays in diagnosis. International guidelines recommend screening IBS patients for celiac disease using serological testing. However, studies published recently have cast doubt on the utility of this.
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    Source:
    The American Journal of Gastroenterology, 18 October 2016. doi:10.1038/ajg.2016.466

    Dr. Vikki Petersen D.C, C.C.N
    Celiac.com 02/23/2017 - IBS, also known as Irritable Bowel Syndrome, is a miserable condition. If you've ever had food poisoning or experienced Montezuma's revenge from travel, you have a good idea of how someone who suffers from IBS may feel. But while your food poisoning passed in a couple of days, imagine what it would be like to live like that each and every day.
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    If you look online, this is what ‘WebMD' has to say about the condition:
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    "In many people who have IBS, eating may trigger symptoms. But for most people, there is not a particular type of food that triggers symptoms."
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    "You can take steps to reduce the possibility that certain foods will cause symptoms, such as avoiding or limiting gas-producing foods (including beans and cabbage), sugarless chewing gum and candy, caffeine, and alcohol."
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    It seems that while a gluten-free diet isn't the answer for 100% of IBS patients, it is definitely a component in enough people suffering from IBS that it would be a shame to not test for it. Do you agree?
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    If you have IBS or know of someone who does, do consider getting testing for celiac disease and gluten sensitivity. Remember that these tests aren't perfect. Even if you test negative, it would do no harm to try a 30 day gluten elimination diet.
    Let me know how it goes and please contact me should you have any questions. Our destination clinic treats patients from across the country and internationally, so you don't need to live locally to receive help. You can call us for a free health analysis at 408-733-0400.
    Reference:
    Gastroenterology. 2013 Jan 25. pii: S0016-5085(13)00135-2. doi: 10.1053/j.gastro.2013.01.049. A Controlled Trial of Gluten-Free Diet in Patients with Irritable Bowel Syndrome-Diarrhea: Effects on Bowel Frequency and Intestinal Function. Vazquez-Roque MI, Camilleri M, Smyrk T, Murray JA, Marietta E, O'Neill J, Carlson P, Lamsam J, Janzow D, Eckert D, Burton D, Zinsmeister AR.

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    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
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    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
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