by Greg Laub, Director, Video, MedPage Today June 28, 2022

A randomized controlled trial presented at Digestive Disease Week looked at the effects of a diet low in FODMAPs (fermentable oligo-, di-, monosaccharides, and polyols) versus traditional dietary advice for patients with irritable bowel syndrome (IBS).

In this MedPage Today video, Emma Halmos, PhD, of Monash University Box Hill Institute in Melbourne, Australia, shares pointers for clinicians looking to implement a FODMAP diet.

Following is a transcript of her remarks:

The FODMAP diet is something that is very much an umbrella term that encompasses fermentable sugars. The most common one that people know of is lactose, which is the fermentable sugar in milk and milk products. But FODMAP refers to not just lactose, but many other sugars that act the same way in the body.

Fructose is another oligosaccharides polyol. And in people with irritable bowel syndrome who have what we call a visceral sensitivity, hypersensitivity of the gut, we find that when we reduce not just one, but all, of these sugars, what it does is in turn reduce gas that's produced in the colon and fluid as well. And this makes people feel better, and controls their symptoms. So the low-FODMAP diet was, is, quite helpful. And a lot of the IBS guidelines are now recommended for first-line dietary therapy.

And there's really two approaches to the FODMAP diet. The traditional one is where you essentially over-restrict for a time and get people seeing if they respond well. And then you go through a post-process of reintroducing certain types of food to identify what's problematic and not. And then long-term, ultimately people find they only need to target a couple of foods to make themselves feel well. That's one approach. And the other is a gentle approach where we might select just a few really, really concentrated FODMAP foods and reduce that. And if that's not enough, we might reduce further.

And if they're a good candidate to try the diet, to select which approach is best for them. If they're already restricting other foods or perhaps they're children or adolescents, or there's another reason why we wouldn't want to be so heavy handed with diet, we might go a gentle approach. And of course for people who prefer that. But if people want to dive ride in and do a short term, more aggressive restriction of FODMAP, then a dietitian can guide them through that as well.

Greg Laub is the Senior Director of Video and currently leads the video and podcast production teams. Follow

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