Challenges of the low FODMAP diet for managing irritable bowel syndrome and approaches to their minimisation and mitigation
Open accessAbstract
Dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is clinically effective and a commonly utilised approach in the management of functional symptoms in irritable bowel syndrome. Despite this, the low FODMAP diet has a number of challenges: it can alter the gut microbiota; impact nutrient intake and diet quality; is complex to understand; requires the patient to be adequately supported to follow the diet accurately and safely; and lastly, not all patients respond to the diet. The current review highlights the evidence for the clinical effectiveness of the low FODMAP diet, but focusses on the challenges associated with the diet to the patient, health professionals and the wider healthcare service. Finally, the review discusses research findings and practical guidance for how these challenges can be minimised and mitigated. The low FODMAP diet is a useful management strategy for irritable bowel syndrome, with data from clinical trials suggesting a 50–80% response rate, and when administered appropriately, the challenges to implementing the diet can be overcome so that these outcomes can be realised effectively and safely in clinical practice.
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Issues with following a low FODMAP diet, as opposed to traditional dietary advice, include the need for a specialist dietitian to implement it, followed by close monitoring to avoid nutritional deficiencies or the development of overly restrictive eating habits.
“Issues with following a low FODMAP diet, as opposed to traditional dietary advice, include the need for a specialist dietitian to implement it, followed by close monitoring to avoid nutritional deficiencies or the development of overly restrictive eating habits.[207][208][209]”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [208]
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British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., et al. (2021) · Gut · doi:10.1136/gutjnl-2021-324598 · Cited by 547 · see citing works
- Authors
- Wilson, B., Cox, S. R., & Whelan, K.
- Affiliations
- King's College London (GB)
- Corresponding author
- Whelan, Kevin
- Venue
- Proceedings of the Nutrition Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-05-29
- Volume
- 80
- Issue
- 1
- Pages
- 19-28
- ISSN
- 0029-6651 (ISSN-L)
- 1475-2719
- OpenAlex
- W3032358717
- Cited by
- 47
- References
- 9
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 9 · 2023: 10 · 2022: 5 · 2021: 4 · 2020: 1
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of The Nutrition Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kenneth Rainin Foundation (KRA000047)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- low FODMAP diet, irritable bowel syndrome, dietary restriction, gut microbiota, nutrient intake, diet quality, patient support, dietary adherence, treatment response, functional gastrointestinal symptoms, clinical practice implementation
- MeSH terms
- Gastrointestinal Microbiome, Disaccharides, Eating, Fermentation, Humans, Monosaccharides, Oligosaccharides, Patient Compliance, Polymers, Treatment Outcome, Irritable Bowel Syndrome, Diet, Carbohydrate-Restricted
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