Sambandet mellan IBS och FODMAPs
Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionABSTRACTTitle: The connection between IBS and FODMAPsAuthor: Helena Hautamäki and Rebecka BertilssonSupervisor: Sofia KlingbergExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-10Background: IBS (Irritable Bowel Syndrome) is a functional gastrointestinal disorder, and is acommon disorder in the western population. The predominant symptoms are diarrhoea,abdominal pain, bloating, constipation, and excessive flatus. Today there are no evidence basedrecommendations concerning dietary factors for patients diagnosed with IBS, but recently certainfactors in the diet that seems to trigger the symptoms have been identified. These factors areshort-chain carbohydrates, Fermentable Oligosaccharides, Disaccharides, Monosaccharides, andPolyols (FODMAPS), which are not completely absorbed in the lumen.Objective: The purpose of this systematic review article is to examine whether there are anyevidence that a diet low in FODMAPs may induce improvement of symptoms in patientsdiagnosed with IBS.Search strategy: The literature search was performed in the databases PubMed, Scopus,Summon and Google Scholar. The keywords were ?Irritable bowel syndrome + FODMAPs?,?Irritable bowel syndrome + diet? and ?FODMAP and diet?.Selection criteria: The inclusion criteria were patients diagnosed with IBS between the ages 18and 69. The exclusion criteria were surgery made in the gastrointestinal tract, othergastrointestinal dysfunctions and pregnancy.Data collection and analysis: Five relevant articles were found whereas two of them didn´tmatch the chosen selection criteria and were therefore excluded. The remaining articles wereexamined according to SBU guidelines. The evidence of the three chosen endpoints bloating,abdominal pain and flatulence were then examined according to the SBU guidelines.Main results: According to two RCTs there are moderate evidence that a dietary treatment lowin FODMAPs gives symptom improvements in flatulence and bloating. A cohort study showslow evidence for the same endpoints. According to all the examined studies, there is low evidencethat a dietary treatment low in FODMAPs improves abdominal pain for patients with IBS.Conclusions: A dietary treatment low in FODMAPs is relevant for symptom improvements offlatulence and bloating. However, the dietary treatment should be individualized, and moreresearch is needed in this area of concern.