Carbohydrates
The low FODMAP diet in the management of irritable bowel syndrome: an evidence-based review of FODMAP restriction, reintroduction and personalisation in clinical practice
K. Whelan,
L. D. Martin,
H. M. Staudacher,
M. C. E. Lomer,
Corresponding Author
K. Whelan
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Correspondence
K. Whelan, Department of Nutritional Sciences, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
E-mail: [email protected]
Search for more papers by this authorL. D. Martin
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Search for more papers by this authorH. M. Staudacher
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Gastroenterology, London, UK
University of Queensland, Faculty of Medicine, Princess Alexandra Southside Clinical Unit, Queensland, Australia
Search for more papers by this authorM. C. E. Lomer
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Gastroenterology, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Nutrition and Dietetics, London, UK
Search for more papers by this authorK. Whelan,
L. D. Martin,
H. M. Staudacher,
M. C. E. Lomer,
Corresponding Author
K. Whelan
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Correspondence
K. Whelan, Department of Nutritional Sciences, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
E-mail: [email protected]
Search for more papers by this authorL. D. Martin
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Search for more papers by this authorH. M. Staudacher
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Gastroenterology, London, UK
University of Queensland, Faculty of Medicine, Princess Alexandra Southside Clinical Unit, Queensland, Australia
Search for more papers by this authorM. C. E. Lomer
King's College London, Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, School of Life Course Sciences, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Gastroenterology, London, UK
Guy's and St Thomas’ NHS Foundation Trust, Department of Nutrition and Dietetics, London, UK
Search for more papers by this authorAbstract
Dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) is effective in the management of functional gastrointestinal symptoms that occur in irritable bowel syndrome (IBS). Numerous reviews have been published regarding the evidence for their restriction in the low FODMAP diet; however, few reviews discuss the implementation of the low FODMAP diet in practice. The aim of this review is to provide practical guidance on patient assessment and the implementation and monitoring of the low FODMAP diet. Broadly speaking, the low FODMAP diet consists of three stages: FODMAP restriction; FODMAP reintroduction; and FODMAP personalisation. These stages can be covered in at least two dietetic appointments. The first appointment focuses on confirmation of diagnosis, comprehensive symptom and dietary assessment, detailed description of FODMAPs and their association with symptom induction, followed by counselling regarding FODMAP restriction. Dietary counselling should be tailored to individual needs and appropriate resources provided. At the second appointment, symptoms and diet are re-assessed and, if restriction has successfully reduced IBS symptoms, education is provided on FODMAP reintroduction to identify foods triggering symptoms. Following this, the patient can follow FODMAP personalisation for which a less restrictive diet is consumed that excludes their personal FODMAP triggers and enables a more diverse dietary intake. This review provides evidence and practice guidance to assist in delivering high-quality clinical service in relation to the low FODMAP diet.
Supporting Information
| Filename | Description |
|---|---|
| jhn12530-sup-0001-OSM1.docxWord document, 32.6 KB | Table S1. Examples of investigations undertaken to rule out organic disease in suspected irritable bowel syndrome (based upon current guidelines in the UK, guidelines in other countries may vary). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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