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Dietary approaches in functional bowel disorders.

Karen Van den Houte1

  • 1Translational Research Center for Gastrointestinal Diseases (TARGID), Department of Chronic Diseases and Metabolism (ChroMeta), KU Leuven, Leuven, Belgium.

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Dietary interventions are crucial for managing functional bowel disorders like irritable bowel syndrome (IBS). This review examines evidence for diets such as the low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet, emphasizing personalized treatment.

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Area of Science:

  • Gastroenterology
  • Dietetics
  • Functional Bowel Disorders

Background:

  • Functional bowel disorders (FBDs) are common, causing chronic gastrointestinal symptoms without structural abnormalities.
  • Their complex pathophysiology necessitates a symptom-directed, personalized treatment approach.
  • Dietary management is a cornerstone of FBD therapy, addressing prevalent food-related symptoms.

Purpose of the Study:

  • To review current evidence on dietary therapies for functional bowel disorders, with a focus on irritable bowel syndrome (IBS).
  • To evaluate the efficacy, rationale, and limitations of various dietary interventions, including the low FODMAP diet.
  • To highlight the importance of individualized, multidisciplinary care for optimizing patient outcomes.

Main Methods:

  • Systematic review of evidence-based dietary guidelines and targeted exclusion diets for FBDs.
  • Analysis of the low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet's role in symptom management.
  • Exploration of alternative dietary strategies like reduced carbohydrate/protein diets and gluten-free options.

Main Results:

  • General dietary advice is recommended as first-line therapy for FBDs.
  • The low FODMAP diet shows significant efficacy for symptom relief in IBS, despite limitations.
  • Other targeted diets (e.g., gluten-free, reduced starch/sucrose) offer alternative management strategies.

Conclusions:

  • Dietary interventions are effective in managing functional bowel disorders, particularly IBS.
  • The low FODMAP diet is a well-studied and valuable tool, but requires careful implementation.
  • Personalized, multidisciplinary approaches are essential for successful long-term management of FBDs.