Review Study: FODMAP Diet for Inflammatory Bowel Disease

This study review examines the benefits and drawbacks of a FODMAP diet for inflammatory bowel diseases (IBDs), mainly represented by ulcerative colitis and Crohn’s disease. The increase in the incidence tends to follow the rapid industrialization and lifestyle of modern societies. FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) consist of molecules that are poorly absorbed in the small intestine and are fermented by bacteria in the colon leading to symptoms such as bloating, flatulence, diarrhea, and abdominal pain. Published in Journal of Medicinal Food 

Reduction of the ingestion of FODMAP could reduce the symptoms and improve the quality of life. This review aimed to summarize some important aspects of IBD and evaluate the effects of this diet on this inflammatory condition. Studies including the term FODMAP (and similar terms) and IBD were selected for this review (MEDLINE database was used PubMed/PMC). A low FODMAP diet may be an effective tool to the management of the common abdominal symptoms in patients with functional gastrointestinal symptoms once these molecules trigger these symptoms. This diet may also reduce the expression of pro-inflammatory markers such as C-reactive protein and fecal calprotectin and may interfere with the microbiome and its metabolites. The use of a low FODMAP diet can bring benefits to the IBD patients, but may also modify their nutritional status. Thus it should be utilized in appropriated conditions, and dietary supplements should be necessary to avoid deficiencies that could be caused by a low FODMAP diet over long periods. We suggest that further investigations are required to elucidate when and how to apply the FODMAP diet in IBD patients.

FODMAP are poorly absorbed in the small intestine and are highly fermentable and osmotic, resulting in the production of gas, bloating, distension, and diarrhea. In contrast, they may play beneficial physiological effects such as modulation of immune function, enhancement of stool bulk and calcium absorption, and reduction in the levels of serum cholesterol and triglycerides. FODMAP also may induce selective stimulation of the growth of microorganisms as Bifidobacteria that play a prebiotic effect and are capable of protecting against colon cancer. These important actions of FODMAP are lost in individuals with diet poor in these molecules.

In this study review, you will learn (link to full text at the end of this post): 

  1. The Potential Role of Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols in Inflammatory Bowel Disease
  2. Pathophysiologic aspects of IBD

  3. Nutrient Losses from diets that restrict fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

  4. IBD and FODMAP: benefits and risks

Conclusion/ The use of a low FODMAP diet may not only result in the relief of the symptoms presented by patients with IBD but also may modify their nutritional status. Thus it should be used in appropriated conditions, and dietary supplements should be necessary to avoid deficiencies that could be caused by a low FODMAP diet over long periods.

We suggest that further investigations are required to elucidate when and how to apply the FODMAP diet in IBD patients once it should be compatible with the symptoms but should not cause nutritional deficiency and induce undesirable consequences for these patients and lead to the worsening of the QoL.

Click Here for Full Text Study