Abstract

MARTINS, Ana; PEQUITO, Ana  and  BALTAZAR, Ana Lúcia. Intestinal Dysbiosis and Irritable Bowel Syndrome: effect of a low diet on FODMAPs. Acta Port Nutr [online]. 2020, n.22, pp.38-41. ISSN 2183-5985.  https://doi.org/10.21011/apn.2020.2207.

Irritable bowel syndrome (IBS) is a multifactorial gastrointestinal disorder, affecting 10% to 25% of the world population. The diagnosis of IBS, according to the Rome IV Criteria, can be made when the individual suffers from recurrent abdominal pain and this is associated with at least two of the following symptoms: pain related to defecation, changes in stool frequency, and changes in the appearance of feces. Evidence suggests that a distortion in the biodiversity and composition of the intestinal microbiota, dysbiosis, interferes with the integrity of the intestine playing an important factor triggering IBS. FODMAP is the acronym for "oligo-, di- and monosaccharides and fermentable polyols". It designates a group of short-chain carbohydrates, osmotically active and highly fermentable in the colon since their absorption is incomplete in the small intestine. Low absorption of FODMAPs in the small intestine may be due to saturation, inhibition, and defects at the level of transporters by the epithelium (fructose), decreased activity of hydrolases (lactose), enzymatic deficits (fructans, galactans), or too large molecules unable to be absorbed by simple diffusion (polyols). The low FODMAPs diet consists of three phases: restriction, reintroduction, and maintenance, and according to some researchers, it can be recommended as first-line therapy for individuals with IBS. Studies show that an intake of up to 0.5 g of FODMAPs (except for lactose) per meal is effective in relieving symptoms in 70% of patients. The adoption of a diet low in FODMAPs reduces prebiotics and available fermentable substrates, which can negatively alter the structure and function of the intestinal microbiota. The prescription of this diet is not easy, requiring the intervention of a nutritionist with knowledge in this area, enabling patient empowerment, long-term control of symptoms, and improvement in the quality of life.

Keywords : FODMAP; Low FODMAPs diet; Dysbiosis; FODMAP; Intestinal microbiota; Irritable bowel syndrome.

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