Diets low in fermentable sugars (low-FODMAP diets) are increasingly adopted by patients with functional gastrointestinal disorders, but outcome predictors are unclear.
Dr Wilder-Smith and colleagues from Switzerland identified factors predictive of an efficacious response to a low-FODMAP diet in functional gastrointestinal disorders patients with fructose or lactose intolerance thereby gaining insights into underlying mechanisms.
The team performed fructose and lactose breath tests in functional gastrointestinal disorders patients to determine intolerance, and malabsorption.
|81% of 584 patients completing the low-FODMAP diet achieved adequate relief|
|Alimentary Pharmacology & Therapeutics|
Patients with fructose or lactose intolerance consumed a low-FODMAP diet, and global adequate symptom relief was assessed after 6–8 weeks and correlated with pre-diet clinical symptoms and breath test results.
A total of 81% of 584 patients completing the low-FODMAP diet achieved adequate relief, without significant differences between functional gastrointestinal disorders subgroups or types of intolerance.
The researchers investigated predictive factors in fructose intolerance, and lactose intolerance.
The research team found that symptom relief was independently and positively predicted in fructose intolerance by chronic diarrhea, and peak breath methane concentrations, and negatively predicted by chronic nausea.
No independent predictive factors emerged for lactose intolerance.
Dr Wilder-Smith's team concludes, "Adequate global symptom relief was achieved with a low-FODMAP diet in a large majority of functional gastrointestinal disorders patients with fructose or lactose intolerance."
"Independent predictors of a satisfactory dietary outcome were only seen in fructose intolerant patients, and were indicative of changes in intestinal host or microbiome metabolism."