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Fatigue
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
Fermentable carbohydrates often go by the acronym FODMAPS, which stands for fermentable oligo-, di-, monosaccharides, and polyols. In sensitive people, this group of carbohydrates can aggravate gut symptoms such as bloating, gas, and stomach pain. A diet low in FODMAPS is recommended for the management of irritable bowel syndrome. A diet low in FODMAPS restricts these high-FODMAP foods: Oligosaccharides: wheat, rye, legumes, garlic, onionsDisaccharides: milk, yogurt, soft cheese (main carb is lactose)Monosaccharides: various fruits, including apples, apricots, cherries, figs, mangoes, nectarines, peaches, pears, and plums; sweeteners such as honey and agave nectar (main carb is fructose)Polyols: certain fruits and vegetables, including blackberries and lychee; mannitol and sorbitol, which is found in some sugar-free gum
Irritable Bowel Syndrome
Published in Nicole M. Farmer, Andres Victor Ardisson Korat, Cooking for Health and Disease Prevention, 2022
Another argument making avoiding gluten controversial in IBS is that removal of gluten-containing foods also leads to the reduction or elimination of other foods such as those high in FODMAPs and others that are thought to cause IBS-like symptoms (Aziz, Hadjivassiliou, and Sanders 2015). While it is difficult to determine if gluten is the causative element, its elimination is associated with symptom amelioration in many IBS patients. Thus, a significant percentage of patients with an IBS diagnosis (whether a false diagnosis or not) may benefit from a trial of avoiding gluten-containing foods. Whether that benefit is because their IBS diagnosis is false (and in reality, they have hidden celiac disease) or because in avoiding gluten-containing foods the person avoids other troublesome components as well, the fact remains that these patients benefit.
Gastrointestinal Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Justine Turner, Sally Schwartz
The current approach to managing the low-FODMAP diet should be a limited period of elimination of all FODMAPs (4–8 weeks at most), followed by staged reintroduction within groupings, under the supervision of a dietitian, and finally a stage of individualized dietary management. At that stage only a few FODMAPs that have been recognized as the main triggers of symptoms should be avoided and only at the amounts that trigger symptoms. Clearly this approach requires careful monitoring of dietary intake and symptoms at all stages using food records or a food diary. Getting to the personalized stage is not a simple process and does require ongoing access to the expertise of a dietitian.
Is there a role for the microbiome in systemic sclerosis?
Published in Expert Review of Clinical Immunology, 2023
Various dietary modifications can profoundly affect the composition of the gut microbiome. For example, transition to a plant-based diet or a diet devoid of gluten has immediate effects on gut microbial communities. A diet low in fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) is commonly recommended to patients with SSc to reduce symptoms, such as gas and bloating. While this intervention has not been studied in RCTs, a recent small study found that patients who adhered to a low FODMAP diet had no appreciable alterations in gut microbial composition, nor GI symptoms, compared with patients who did not adhere to a low FODMAP diet [17]. There is also some concern that patients consuming a low-FODMAP diet may experience reductions in beneficial commensal microbes, as well as micronutrient deficiencies, particularly if the low FODMAP diet is consumed long-term. It is important to remember that elimination of high FODMAP foods is only the first step in this process; selective and sequential re-introduction of foods containing individual FODMAPs is critical for achieving dietary diversification.
Effects of fecal microbiota transplantation in subjects with irritable bowel syndrome are mirrored by changes in gut microbiome
Published in Gut Microbes, 2020
Rasmus Goll, Peter Holger Johnsen, Erik Hjerde, Joseph Diab, Per Christian Valle, Frank Hilpusch, Jorunn Pauline Cavanagh
The involvement of certain functional subsystems raises interesting questions about the basic pathophysiology of IBS. When we consider the role of a FODMAP-reduced diet in IBS treatment, SCFA and carbohydrate signals are of special interest. FODMAPs are a group of short-chain carbohydrates hypothesized to induce symptoms, possibly by altered colonic fermentation of these compounds, leading to a change in the functional output, which then induces gut symptoms.6,8 A recent study found reduced levels of inflammatory cytokines, an altered gut microbiota profile, and reduced levels of short-chain fatty acids to be associated with symptom relief from a low-FODMAP diet.32 Here, we can demonstrate that relative to Donor stool, the fecal samples from IBS patients have a lower representation of carbohydrate-related subsystems. In the Effect group, increases in D-Galacturonate and D-Glucuronate utilization, D-ribose utilization, L-rhamnose utilization, and Lactose and Galactose uptake and utilization were observed after 12 months. The L-rhamnose pathway was recently reported to be among the top five microbial pathways associated with 53% of fecal metabolites found in 479 unrelated individuals.31 Thus, the functional output of our FMT treatment closes the gap to the Donor profile in the Effect group. This change is not seen in the No effect group. All other subsystem clusters show a tendency of convergence toward the Donor profile in both the Effect and No effect groups.
Recent advances in the pharmacological management of constipation predominant irritable bowel syndrome
Published in Expert Opinion on Pharmacotherapy, 2020
Karolina Niewinna, Anna Zielińska, Jakub Fichna
Exacerbation of IBS symptoms and alterations in fecal microbiota can be observed with certain foods [4,14]. Traditionally IBS-C patients were advised to consume high amounts of fiber to mitigate the symptoms, however there was little-specific data derived from controlled randomized trials concerning this approach. Then, attention has been brought to FODMAPs: fermentable carbohydrates that include fructo-oligosaccharides, galacto-oligosaccharides, disaccharides (lactose), monosaccharides (fructose) and polyols (sorbitol). Digestion of these products can result in bloating, diarrhea, gas production, pain and constipation [21]. High amounts of insoluble fiber (vegetables, wheat), usually containing large amounts of FODMAPs exacerbate the symptoms in IBS patients because of their fermentation and osmotic effect [14,22].