The Six-food Elimination Diet Improves Symptoms of Functional Dyspepsia

Functional dyspepsia (FD) is a common disorder of gut-brain interaction that impairs quality of life (QoL).¹ Its pathophysiology is complex and incompletely understood. Recent studies suggest duodenal low-grade inflammation and increased permeability may contribute, although triggers remain unclear, potentially involving luminal antigens such as food or microbial components.^2-5 Exclusion diets, including low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) or gluten-free, have been attempted, but no standardized therapy exists. In eosinophilic esophagitis, the 6-food elimination diet (6FED) reduces eosinophils and improves symptoms.⁶ In FD, however, it is unclear whether these foods induce symptoms and/or duodenal alterations and what underlying mechanism plays a role. We evaluated the effects of 6FED on duodenal alterations, symptoms, and gastric sensorimotor function in adults with predominant postprandial distress syndrome (PDS) per Rome IV criteria.