History of the low FODMAP diet

Abstract

It has long been known that many short-chain carbohydrates can induce abdominal symptoms that are similar to those in patients with irritable bowel syndrome (IBS). It was hypothesized that restricting the intake of all short-chain carbohydrates that are either slowly absorbed or not digested in the small intestine should be considered together because they all have similar effects on the intestine by distending the lumen. These groups of carbohydrates were called, Fermentable, Oligosaccharides, Disaccharides and Monosaccharides and Polyols (FODMAPs), because of the lack of a known collective term. By reducing their dietary intake, it was also hypothesized that abdominal symptoms in patients with IBS would be alleviated in patients with visceral sensitivity and a low FODMAP diet was subsequently designed. Over the last 12 years, the mechanisms of action, food content of FODMAPs and efficacy of the diet, among other aspects have been intensively studied. In many parts of the world, the low FODMAP diet is now considered a front-line therapy for IBS.

Keywords: carbohydrate malabsorption; fructans; fructose; galacto-oligosaccharides; lactose intolerance; sorbitol; xylitol.