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Celiac.com 01/27/2025 - Persistent digestive symptoms are a common challenge for individuals with celiac disease and gluten-related disorders, even after switching to a gluten-free diet. This summary explores the potential role of the low-FODMAP diet as an additional therapeutic strategy to manage symptoms in these populations. FODMAPs are fermentable carbohydrates found in a variety of foods, and their restriction has shown promise for improving gastrointestinal health. This study reviews the relationship between FODMAPs, celiac disease, and non-celiac gluten or wheat sensitivity. What Are FODMAPs? FODMAPs are short-chain carbohydrates that can cause digestive issues for some people. These include: Lactose: Found in dairy products. Fructose: Present in honey, apples, and pears. Fructans: Found in wheat, garlic, onions, and rye. Galactans: Found in legumes and certain vegetables. Polyols: Sugar alcohols present in fruits, artificial sweeteners, and some vegetables. In people who are sensitive, these compounds may be poorly absorbed in the small intestine, causing bloating, diarrhea, and abdominal discomfort due to their fermentation by gut bacteria. The low-FODMAP diet reduces these foods to alleviate symptoms. Persistent Symptoms in Celiac Disease Despite strict adherence to a gluten-free diet, many individuals with celiac disease report ongoing gastrointestinal issues, including bloating, abdominal pain, and irregular bowel movements. Several factors may contribute to these symptoms, such as undiagnosed conditions like irritable bowel syndrome or small intestinal bacterial overgrowth. Research shows that a significant portion of celiac patients experience symptoms resembling irritable bowel syndrome, suggesting that dietary factors beyond gluten could play a role. This connection has led to growing interest in the low-FODMAP diet as a complementary dietary approach. Low-FODMAP Diet and Celiac Disease Several studies have explored how reducing FODMAP intake may benefit individuals with celiac disease. Key findings include: Symptom Improvement: Studies consistently show that a low-FODMAP diet can reduce gastrointestinal symptoms in celiac patients who continue to experience discomfort on a gluten-free diet. Psychological Benefits: Improved digestive health has been linked to better psychological well-being and quality of life in celiac patients following a low-FODMAP diet. Minimal Microbiota Impact: Research indicates that while a low-FODMAP diet may slightly alter gut bacteria, the overall diversity remains unaffected, reducing concerns about long-term harm to gut health. These findings suggest that a combined gluten-free and low-FODMAP diet could be an effective strategy for managing persistent symptoms in celiac patients. Low-FODMAP Diet and Non-Celiac Gluten or Wheat Sensitivity For individuals with non-celiac gluten or wheat sensitivity, digestive symptoms such as bloating and diarrhea are often indistinguishable from those of irritable bowel syndrome. Recent research highlights that FODMAPs, particularly fructans found in wheat, may trigger symptoms in these individuals. Studies comparing gluten-free diets and low-FODMAP diets for these patients reveal that FODMAP restriction consistently reduces symptoms, particularly abdominal pain and bloating. This suggests that for some people, sensitivity to FODMAPs rather than gluten may be the primary driver of their discomfort. The Role of Dieticians and Personalized Nutrition Implementing a low-FODMAP diet requires careful planning to ensure balanced nutrition. Dieticians play a crucial role in guiding individuals to safely reduce FODMAP intake without compromising essential nutrients. Long-term adherence to a restrictive diet may have risks, so professional support is essential for tailoring dietary strategies to individual needs. Why This Matters for Celiac Patients The findings from this review hold significant promise for individuals with celiac disease and gluten-related disorders who struggle with unresolved digestive symptoms. By addressing the broader range of dietary triggers, a low-FODMAP diet can enhance symptom management and improve overall quality of life. While a gluten-free diet remains the cornerstone of treatment for celiac disease, the low-FODMAP diet offers a valuable addition for those seeking greater symptom relief. This research highlights the importance of personalized dietary approaches and reinforces the potential for dietary modifications to play a central role in managing complex digestive conditions. Read more at: mdpi.com Watch the video version of this article:

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