gh1112_Lembo1.pdf - Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome Suma Magge MD and Anthony Lembo MD Dr Magge is a Fellow and Dr Lembo is an

gh1112_Lembo1.pdf - Low-FODMAP Diet for Treatment of...

This preview shows page 1 - 3 out of 7 pages.

Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome Suma Magge, MD, and Anthony Lembo, MD Keywords Irritable bowel syndrome, FODMAPs, small intestinal bacterial overgrowth, food allergy, food intolerance, hydrogen breath testing Dr. Magge is a Fellow and Dr. Lembo is an Associate Professor of Medicine in the Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Address correspondence to: Dr. Anthony Lembo Division of Gastroenterology Beth Israel Deaconess Medical Center Rabb Rose 1 330 Brookline Avenue Boston, MA 02215; Tel: 617-667-2138; Fax: 617-667-1171; E-mail: [email protected] Abstract: Functional bowel disorders, including irritable bowel syndrome (IBS), are common disorders that have a significant impact on patients’ quality of life. These disorders present major challenges to healthcare providers, as few effective medical thera- pies are currently available. Recently, there has been increasing interest in dietary therapies for IBS, particularly a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Since ingestion of FODMAPs increases the delivery of readily fermentable substrates and water to the distal small intestine and colon—which results in luminal disten- tion and gas—the reduction of FODMAPs in a patient’s diet may improve functional gastrointestinal symptoms. This paper will review the pathophysiology of IBS and the role of FODMAPs for the treatment of this condition. I rritable bowel syndrome (IBS) is a chronic, often disabling, func- tional disorder characterized by abdominal pain and changes in bowel habits. 1 The prevalence of IBS in the US general population varies between 8% and 20% depending on diagnostic criteria and the population that is evaluated. 2 Most studies report a higher prevalence of IBS in women than men. 3 The average medical expenditure for IBS in the United States is estimated to be $1.35 billion in direct costs and $205 million in indirect costs. 4 IBS also accounts for almost half of all visits to gastroenterologists. The pathophysiology of IBS is incompletely understood, and treatment options are limited, partly due to the heterogeneity of the IBS population. 5 Nearly two thirds of IBS patients report that their symptoms are related to food. 6 The pathogenic mechanism by which food induces IBS symptoms remains unclear, but it includes visceral hypersensitivity, altered motility, abnormal colonic fermen- tation, and sugar malabsorption, all of which lead to increased gas production and luminal distention. 7 The use of elimination diets for the treatment of IBS has yielded conflicting results, although this treatment option has been slightly more successful in IBS patients who have diarrhea. 8 However, elimination diets can result in dietary restrictions that can be burdensome to patients and can potentially Gastroenterology & Hepatology Volume 8, Issue 11 November 2012 739
Image of page 1
740 Gastroenterology & Hepatology Volume 8, Issue 11 November 2012 M A G G E A N D L E M B O compromise their nutritional health. In addition, there is
Image of page 2
Image of page 3

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture