Reference Number: 64
Intolerance & Sensitivity: FODMAPS
IBS is a debilitating condition that markedly affects quality of life. The chronic nature, high prevalence and associated comorbidities contribute to the considerable economic burden of IBS. The pathophysiology of IBS is not completely understood and evidence to guide management is variable. Interest in dietary intervention continues to grow rapidly. Ileostomy and MRI studies have demonstrated that some fermentable carbohydrates increase ileal luminal water content and breath hydrogen testing studies have demonstrated that some carbohydrates also increase colonic hydrogen production. The effects of fermentable carbohydrates on gastrointestinal symptoms have also been well described in blinded, controlled trials. Dietary restriction of fermentable carbohydrates (popularly termed the ‘low FODMAP diet’) has received considerable attention. An emerging body of research now demonstrates the efficacy of fermentable carbohydrate restriction in IBS; however, limitations still exist with this approach owing to a limited number of randomized trials, in part due to the fundamental difficulty of placebo control in dietary trials. Evidence also indicates that the diet can influence the gut microbiota and nutrient intake. Fermentable carbohydrate restriction in people with IBS is promising, but the effects on gastrointestinal health require further investigation.
SIGNIFICANCE OF THIS STUDY
Dietary intervention studies have showed promising results in symptom reduction in IBS patients by incorporation low FODMAP diets and this includes sourdough bread. However, latest trials have also shown that the low-FODMAP diet may also be associated with marked changes in gut microbiota specifically reduction in microbiota with prebiotic properties. Therefore although sourdough bread maybe a lot more easier to digest for IBS patients due to its low FODMAP status, it is also important to include prebiotic foods which do not contain fructan oligosaccharides as the main dietary fibre source.