The acronym FODMAPs (which stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) was developed to describe these poorly absorbed, short-chain carbohydrates
FODMAPs are poorly absorbed in the small intestine and reach the colon undigested
- cause an osmotic increase of water content in the intestines and increased gas production due to bacterial fermentation (1,2)
- occurs both in healthy person and in patients with IBS, where it is thought to cause symptoms due to visceral hypersensitivity and altered motility (2,3)
A treatment course of the low FODMAP diet commences with an elimination period of 4-8 weeks, excluding or restricting foods high in FODMAPs
- when symptom relief is reported, foods high in FODMAPs are reintroduced one by one to identify the type and amount of FODMAPs, which can be tolerated
- careful monitoring of symptoms during this phase allows for development of the final, personalization phase where patients continue an individualized diet that maximizes diet variety and minimizes triggers (4)
Patient information on the FODMAP diet
Screening patients who are being considered for any elimination diet for eating disorders or disordered eating is recommended given the potential harm in this population (4).
Reference:
- Barrett JS, Gearry RB, Muir JG, et al. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther. 2010;31:874-882
- Shepherd SJ, Lomer MCE, Gibson PR. Short-chain carbohydrates and functional gastrointestinal disorders. Am J Gastroenterol. 2013;108:707-717.
- Barbara G, Cremon C, De Giorgio R, et al. Mechanisms underlying visceral hypersensitivity in irritable bowel syndrome. Curr Gastroenterol Rep. 2011;13:308-315.
- Wang X J, Thakur E, Shapiro J. Non-pharmaceutical treatments for irritable bowel syndrome. BMJ 2024;387 :e075777.