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All that a physician should know about FODMAPs

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Abstract

A diet low in poorly absorbed, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is now considered as an effective strategy for symptoms control in patients with irritable bowel syndrome (IBS). The low FODMAP diet is administered in three phases, namely restriction of all dietary FODMAPs followed by rechallenge and then reintroduction of specific FODMAPs according to the tolerance of patients. A dietician should be involved in patients in whom a low FODMAP diet is planned. While restricting high FODMAPs, it is pertinent that patients are advised a well-balanced diet and suitable alternatives with low FODMAP contents in each food groups are prescribed. Strict adherence to a low FODMAP diet has been shown to improve symptoms, stool output, quality of life, and the overall well-being of patients with IBS. For those who do not respond to this dietary approach, a normal diet may be initiated and other treatment strategies (dietary or nondietary) should be considered. Interestingly, the low FODMAP diet has also been tried in other functional disorders, nonceliac gluten sensitivity, and even inflammatory bowel disease. Since the concept of FODMAP is relatively new, there is only limited data on the content of FODMAP in the Indian food items and there is a need to address this question. There is also a need for well-designed and adequately powered studies to explore the efficacy of low FODMAP diet in patients with IBS. In the present review article, we have compiled all the relevant information about FODMAPs with an objective to provide comprehensive information on FODMAPs to a physician.

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Funding

Wajiha Mehtab acknowledges the University Grants Commission for support of her fellowship.

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Authors and Affiliations

  1. Department of Home Science, Lady Irwin College, University of Delhi, New Delhi, 110 001, India

    Wajiha Mehtab

  2. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Wajiha Mehtab, Ashish Agarwal, Namrata Singh & Govind K. Makharia

  3. Department of Food Technology, Lakshmibai College, University of Delhi, New Delhi, 110 052, India

    Anita Malhotra

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  1. Wajiha Mehtab
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Correspondence to Govind K. Makharia.

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Mehtab, W., Agarwal, A., Singh, N. et al. All that a physician should know about FODMAPs. Indian J Gastroenterol 38, 378–390 (2019). https://doi.org/10.1007/s12664-019-01002-0

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