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Revista Portuguesa de Medicina Geral e Familiar

Print version ISSN 2182-5173

Abstract

OLIVEIRA, Paulo Diogo Terroso Mesquita et al. The LOW-FODMAP diet reduces symptoms of irritable bowel syndrome? An evidence-based review. Rev Port Med Geral Fam [online]. 2020, vol.36, n.2, pp.126-134. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i2.12545.

Objective: We aimed to review the evidence for the efficacy of a low FODMAP (fermentable oligo-, diand monosaccharides and polyols) diet in the management of gastrointestinal symptoms in irritable bowel syndrome (IBS). Methods: We searched MEDLINE/PubMed, DARE, Trip DataBase, Evidence-based Medicine, Clinical Evidence, Web of Science, Canadian Medical Association Practice Guidelines, National Guidelines Clearing House and The Cochrane Library databases for guidelines, meta-analysis and systematic reviews published in English between 2009 and 2017, using the MeSH terms ‘irritable bowel syndrome’, ‘signs and symptoms’, ‘diet therapy’ and the non-MeSH term ‘FODMAPs’. The Strength of Recommendation Taxonomy (SORT) scale was used to determine levels of evidence and strength of recommendations. Results: Of 203 articles found, 11 studies were included: three meta-analyses, three systematic reviews, and five guidelines. There is evidence supporting the efficacy of a low FODMAP diet in improving gastrointestinal symptoms in IBS patients, mainly bloating and abdominal pain, especially in the diarrhea-predominant and mixed subtypes. Some studies show a greater improvement after six weeks. A low FODMAP diet seems to be at least as effective as traditional dietary advice for IBS. Some guidelines recommend this diet in the management of IBS patients, especially when traditional dietary advice is not effective. Conclusions: There is enough evidence to recommend a low FODMAP diet in the management of diarrhea-predominant and mixed subtypes IBS patients with bloating and abdominal pain (grade of recommendation B). There is no sufficient evidence on the long-term efficacy and safety of this diet.

Keywords : FODMAP; Irritable bowel syndrome; Gastrointestinal signs and symptoms; Diet therapy.

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