Provided by TAP Integrative

Nearly one in five school-aged children suffers from the abdominal discomfort and other symptoms associated with irritable bowel syndrome (IBS). Specific foods—often those with fermentable carbohydrates—can trigger those symptoms. Recent research has focused on the effects of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (known as the low FODMAP diet) in IBS. In adults, this diet has improved symptoms in as little as 48 hours, but until now no randomized, controlled trial had been conducted in children.

A 2015 double-blind crossover study including 33 children with IBS has found that children too can benefit from a FODMAP-restricted diet. In the study, participants underwent a 1-week baseline assessment before being randomized to a low-FODMAP diet or a typical American childhood diet (TACD). After a 5-day washout period, participants were crossed over to the other diet. Researchers assessed gastrointestinal symptoms, with the primary outcome being abdominal pain. Other observations included gut microbial composition and metabolic capacity.

The children experienced fewer abdominal pain episodes daily during the low FODMAP diet vs. the TACD (1.1 ± 0.2 episodes/day vs. 1.7 ± 0.4, P<0.05) and compared to baseline (1.4 ± 0.2, P<0.01). Some gut microbiome biomarkers were associated with a better response to the low-FODMAP diet. The children who responded best to the diet had higher levels of organisms with greater saccharolytic metabolic capacity (eg, Bacteroides, Ruminococcaceae, Faecali-bacterium prausnitzii) and certain genes and genomes that relate to carbohydrate metabolism.

This study tells us that children with IBS may experience symptom relief by eliminating or restricting high-FODMAP foods. Those include foods that contain fructose, lactose, fructans, galactans, and polyols. All of these are osmotic, meaning they pull water into the GI tract and can be fermented by GI bacteria. Australia’s Monash University, where the FODMAP concept was developed, offers a number of resources for those who want to learn more. Further research into the gut microbiome may provide a way to tailor the diet more specifically to each individual’s sensitivities.

 

Chumpitazi BP, Cope JL, Hollister EB, et al. Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Aliment Pharmacol Ther. 2015;42(4):418-427.


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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.