Dietary intolerances to fructose, fructans and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are common, yet poorly recognized and managed. Over the last decade, they have come to the forefront because of new knowledge on the mechanisms and treatment of these conditions. Patients with these problems often present with unexplained bloating, belching, distension, gas, abdominal pain, or diarrhea. Here, we have examined the most up-to-date research on these food-related intolerances, discussed controversies, and have provided some guidelines for the dietary management of these conditions. Breath testing for carbohydrate intolerance appears to be standardized and essential for the diagnosis and management of these conditions, especially in the Western population. While current research shows that the FODMAP diet may be effective in treating some patients with irritable bowel syndrome, additional research is needed to identify more foods items that are high in FODMAPs, and to assess the long-term efficacy and safety of dietary interventions.
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We thank Yeong Yeh Lee MD for providing assistance with the manuscript
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Conflict of Interest
Satish S. C. Rao declares no conflict of interest. Amy Fedewa is employed by Georgia Regents Medical Center.
Human and Animal Rights and Informed Consent
This article does contains studies with human subjects performed by the authors that were approved by ethics boards.
This article is part of the Topical Collection on Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract
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Fedewa, A., Rao, S.S.C. Dietary Fructose Intolerance, Fructan Intolerance and FODMAPs. Curr Gastroenterol Rep 16, 370 (2014). https://doi.org/10.1007/s11894-013-0370-0
- Fructose intolerance
- Fructose malabsorption
- Fructan intolerance
- Breath testing
- Irritable bowel syndrome