Mehtab Wajiha, Agarwal Ashish, Singh Namrata, Malhotra Anita, Makharia Govind K
Department of Home Science, Lady Irwin College, University of Delhi, New Delhi, 110 001, India.
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Indian J Gastroenterol. 2019 Oct;38(5):378-390. doi: 10.1007/s12664-019-01002-0. Epub 2019 Dec 4.
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.
低可吸收性、可发酵的寡糖、双糖、单糖和多元醇(FODMAPs)饮食现在被认为是控制肠易激综合征(IBS)患者症状的有效策略。低FODMAP饮食分三个阶段进行,即限制所有饮食中的FODMAPs,随后进行激发试验,然后根据患者的耐受性重新引入特定的FODMAPs。计划采用低FODMAP饮食的患者应有营养师参与。在限制高FODMAPs的同时,建议患者保持均衡饮食,并为每个食物组开具低FODMAP含量的合适替代食物。严格坚持低FODMAP饮食已被证明可改善IBS患者的症状、粪便排出量、生活质量和整体健康状况。对于那些对这种饮食方法无反应的患者,可恢复正常饮食,并应考虑其他治疗策略(饮食或非饮食策略)。有趣的是,低FODMAP饮食也已在其他功能性疾病、非乳糜泻性麸质敏感甚至炎症性肠病中进行尝试。由于FODMAP的概念相对较新,关于印度食物中FODMAP含量的数据有限,因此有必要解决这个问题。还需要设计良好且有足够效力的研究来探索低FODMAP饮食对IBS患者的疗效。在本综述文章中,我们汇编了所有关于FODMAPs的相关信息,目的是向医生提供有关FODMAPs的全面信息。