Translating the Science of the Low FODMAP Diet to Daily Living
NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #175 Carol Rees Parrish, M.S., R.D., Series Editor When a Registered Dietitian Becomes the Patient: Translating the Science of the Low FODMAP Diet to Daily Living Wendy Phillips Janelle Walker Irritable Bowel Syndrome (IBS) can severely affect quality of life due to abdominal pain, bloating, diarrhea and/or constipation. Symptoms can be improved by following a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), but implementation of this restrictive diet can be challenging. This article provides guidance for all 3 phases of the low FODMAP diet from an IBS patient, who utilized her knowledge as a registered dietitian nutritionist to successfully resolve symptoms, discontinue IBS-related medications, and maintain a nutritionally complete diet. INTRODUCTION rritable bowel syndrome (IBS) is a functional is often used, including medication management gastrointestinal (GI) disorder that can severely of symptoms, stress management including affect quality of life due to abdominal pain, biofeedback, and dietary intervention.1,2 This I 1,2 bloating, diarrhea, and/or constipation. The article focuses specifically on the implementation pathophysiology is complex and multifactorial, of a low FODMAP (fermentable oligosaccharides, including visceral hypersensitivity3, alterations in disaccharides, monosaccharides and polyols) diet, the GI microbiome,4-8 and psychosocial factors which has been shown to reduce symptoms in those including the brain-gut axis.9 Often, IBS is not with IBS and is included in the National Institute diagnosed until other causes for symptoms for Health and Care Excellence Clinical Guidelines have been ruled out, such as cancer, infectious for IBS.2 colitis, inflammatory bowel disease, or celiac IBS is divided into four categories: IBS-D (IBS disease.10 Since the pathophysiology of IBS is with diarrhea), IBS-C (IBS with constipation), multifactorial, more than one treatment method IBS-M (IBS with mixed symptoms), and IBS-U (IBS un-subtyped).
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