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Celiac.com 08/18/2022 - There's been some evidence that diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), and other ingredients, can help improve symptoms of irritable bowel syndrome. In many cases, diet can trigger or worsen symptoms of IBS. Many IBS patients try restrictive diets to relieve their symptoms, but there's no good information on which diets might be effective, and advisable. A team of researchers recently conducted a systematic review and network meta-analysis of randomized-controlled trials (RCTs) reviewing the efficacy of food restriction diets in IBS. The research team included Seung Jung Yu, Hong Sub Lee, Hyeon Jeong Gung, Ju Seok Kim, Ki Bae Kim, Yong Hwan Kwon, Jae Hak Kim, Hoon Sup Koo, Hyun-Deok Shin, Sam Ryong Jee, Han Byul Lee, Jeehyoung Kim, and Hye-Won Park. To get good data for their systematic review and network meta-analysis, the research team searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov databases until July 21, 2021, to retrieve RCTs assessing the efficacy of restriction diets in adults with IBS. They then had two independent reviewers conduct the eligibility assessment and data abstraction. For the study, the team included RCTs that compared a restriction diet with a control diet, and assessed any improvements in global IBS symptoms. In all, the team found nearly two thousand citations. After full-text screening, they found fourteen RCTs that were eligible for the systematic review and network meta-analysis. Diet Low in FODMAPs, Starch, and Sucrose Works Best The team's analysis showed that a starch- and sucrose-reduced diet and a diet with low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) showed significantly better results than a usual diet. Symptom flare-ups in patients on a gluten-free diet were also significantly lower than in those on high-gluten diets. These findings showed that a diet low in FODMAPs, starch, and sucrose works best to reduce IBS symptoms. There are more studies to conduct to prove the benefits of these dietary restrictions on IBS symptoms, but these findings are definitely interesting for anyone suffering from IBS. Read the full article from the Korean Journal of Gastroenterology The researchers in this study are variously affiliated with the IBS Research Study Group of the Korean Society of Neurogastroenterology and Motility Department of Internal Medicine, Inje University Busan Paik Hospital, Busan; Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon; Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon; Department of Internal Medicine, Chungbuk National University Hospital, Cheongju; Department of Internal Medicine, Kyungpook National University Hospital, Daegu; Department of Internal Medicine, Dongguk University College of Medicine, Goyang; Department of Internal Medicine, Konyang University Hospital, Daejeon; Department of Internal Medicine, Dankook University Hospital, Cheonan; Department of Public Health, Ajou University Graduate School of Public Health, Suwon; Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul; Inje University Medical Library, Busan, Korea.

Celiac.com 08/04/2021 - Dietary restriction of fermentable carbohydrates (a low-FODMAP diet) is getting a good deal of attention as a potential method for reducing symptoms in patients with irritable bowel syndrome (IBS), particularly in combination with a gluten-free diet. Several studies have associated IBS with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in the gastrointestinal (GI) system of adults with IBS. A team of researchers recently set out to investigate the effects of a low FODMAP-gluten free diet (LF-GFD) on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS. The research team included Kaveh Naseri, Hossein Dabiri, Mohammad Rostami‑Nejad, Abbas Yadegar, Hamidreza Houri, Meysam Olfatifar, Amir Sadeghi, Saeede Saadati, Carolina Ciacci, Paola Iovino, and Mohammad Reza Zali. They are variously affiliated with the Celiac Disease Department, Gastroenterology and Liver Diseases; the Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and the Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Shahid Arabi Ave., Yemen St., Velenjak, Tehran, Iran. In their clinical trial study, the team put 42 IBS patients, with Rome IV criteria, on a low-FODMAP, gluten-free diet for 6 weeks and assessed symptoms using the IBS symptom severity scoring (IBS-SSS), and collected and analyzed fecal samples by quantitative 16 S rRNA PCR assay at baseline, and after the gluten-free diet. They compared gut microbiota diversity at baseline and after 6 weeks of dietary intervention, and analyzed all fecal calprotectin using the ELISA method. Thirty patients, ranging in age from about 25 to 49 years old, completed the six-week diet. After the diet, they showed substantially reduced IBS-SSS overall, compared to the baseline scores. The team noted significant microbial differences in fecal samples taken before and after the dietary period. They found a significant increase in Bacteroidetes, and a decrease in the ratio of Firmicutes to Bacteroidetes (F/B) after the dietary intervention, and also noted decreased FC values. The team's results suggest that IBS patients on a low FODMAP-gluten-free diet show marked reduction in IBS symptom severity, along with reduced FC level after normalization of gut microbiota. The team advocates for more rigorous trials to better assess long-term efficacy and safety of a a low FODMAP-gluten free diet for personalized nutrition in IBS. Read more in BMC Gastroenterol (2021) 21:292

Celiac.com 03/06/2019 - FODMAPs is an acronym, short for “fermentable, oligosaccharides, disaccharides, monosaccharides and polyols.” FODMAPs is a single name for a bunch of different molecules, common in many in foods, that are poorly absorbed by some people. People who can’t tolerate FODMAPs can suffer celiac-like gastrointestinal symptoms. A low FODMAP diet has been shown to help reduce symptoms of IBS, and could be helpful to some people with celiac disease. FODMAPs have also been shown to play a role in non-celiac gluten sensitivity (NCGS). Now, a new app can help people zero in on FODMAPs in food. FODMAPS Trigger Celiac-Like Symptoms in Some People In case you didn’t know, there’s a group of carbohydrates called FODMAPs that may play trigger celiac-like symptoms in certain sensitive people. New research shows that reducing or avoiding FODMAPs, which are poorly absorbed by the gastrointestinal tract, can help to alleviate symptoms of IBS. A Low FODMAP diet works by restricting foods that are high in FODMAPs. Some people with celiacs who experience GI symptoms on a gluten-free diet, and some people with IBS may benefit from eliminating FODMAPS. High FODMAP foods include, but are not limited to: apricots avocado beans cherries dairy fruits garlic high fructose corn syrup honey legumes (soy) lentils maltitol mannitol nectarines onion peaches plums sorbitol wheat xylitol FODMAPs and Gluten-sensitivity in IBS? Some research points to a connection or connections between FODMAPs and gluten-sensitivity in IBS. Doctors have been working to figure out the best dietary strategies, including gluten-free, wheat-free and low FODMAP diets, for the management of IBS symptoms. A recent study of IBS patients shows that rye bread low in FODMAPs can reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms, compared to regular rye bread. APP Helps You Avoid FODMAPs Researchers with the Department of Gastroenterology at Monash University in Australia have developed a diet and related smartphone application to help manage gastrointestinal symptoms associated with Irritable bowel syndrome (IBS) The app is available on both iPhone and Android. Users in over 100 countries worldwide have helped the app become the most popular medical app in over 50 countries. Traffic Lights for FODMAPS The app is based on a comprehensive database of FODMAP content in food, and lists FODMAP foods with a traffic light system and by serving size. Foods coded red are high in FODMAPs and should be avoided, orange coded foods are moderate in FODMAPs and may be tolerated by some people. Foods coded green are low in FODMAPs and are safe to eat. The app features specific food serving size suggestions help users know how much of a given food is safe to eat. The app also contains other information about IBS as well as recipes and meal ideas to help IBS patients interpret and follow the diet. Proceeds from the sale of the application will go towards funding further research. More information about the app can be found on the Monash University website. Read more at: Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity

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. 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: World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi:  10.3748/wjg.v24.i11.1259