Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome
Abstract
Background and Aim: Reduction of short‐chain poorly absorbed carbohydrates (FODMAPs) in the diet reduces symptoms of irritable bowel syndrome (IBS). In the present study, we aimed to compare the patterns of breath hydrogen and methane and symptoms produced in response to diets that differed only in FODMAP content. Methods: Fifteen healthy subjects and 15 with IBS (Rome III criteria) undertook a single‐blind, crossover intervention trial involving consuming provided diets that were either low (9 g/day) or high (50 g/day) in FODMAPs for 2 days. Food and gastrointestinal symptom diaries were kept and breath samples collected hourly over 14 h on day 2 of each diet. Results: Higher levels of breath hydrogen were produced over the entire day with the high FODMAP diet for healthy volunteers (181 ± 77 ppm.14 h vs 43 ± 18; mean ± SD P < 0.0001) and patients with IBS (242 ± 79 vs 62 ± 23; P < 0.0001), who had higher levels during each dietary period than the controls (P < 0.05). Breath methane, produced by 10 subjects within each group, was reduced with the high FODMAP intake in healthy subjects (47 ± 29 vs 109 ± 77; P = 0.043), but was not different in patients with IBS (126 ± 153 vs 86 ± 72). Gastrointestinal symptoms and lethargy were significantly induced by the high FODMAP diet in patients with IBS, while only increased flatus production was reported by healthy volunteers. Conclusions: Dietary FODMAPs induce prolonged hydrogen production in the intestine that is greater in IBS, influence the amount of methane produced, and induce gastrointestinal and systemic symptoms experienced by patients with IBS. The results offer mechanisms underlying the efficacy of the low FODMAP diet in IBS.
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Prebiotics and dietary manipulation have shown benefit in the treatment of IBS.
“Other approaches targeting the intestinal microbiota that have shown benefit in the treatment of IBS include prebiotics (163) and dietary manipulation (127).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [127]
A diet rich in FODMAPs increases abdominal pain, bloating and flatulence in IBS patients.
“Ong et al [274] have recently shown that a diet rich in FODMAPs increases abdominal pain, bloating and flatulence in IBS patients”
From Gut microbiota role in irritable bowel syndrome: New therapeutic strategies (2016) · cites this paper as [274]
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- Authors
- Ong, D. K., Mitchell, S. B., Barrett, J. S., Shepherd, S. J., Irving, P. M., Biesiekierski, J. R., Smith, S., Gibson, P. R., & Muir, J. G.
- Affiliations
- Deakin University (AU)
- Eastern Health (AU)
- Corresponding author
- Muir, Jane G
- Venue
- Journal of Gastroenterology and Hepatology
- Publisher
- Wiley
- Published
- 2010-07-21
- Volume
- 25
- Issue
- 8
- Pages
- 1366-1373
- ISSN
- 0815-9319 (ISSN-L)
- 1440-1746
- OpenAlex
- W2129566057
- Cited by
- 583
- References
- 37
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 21 · 2023: 18 · 2022: 32 · 2021: 45 · 2020: 37 · 2019: 46 · 2018: 46 · 2017: 73 · 2016: 59 · 2015: 46 · 2014: 44 · 2013: 44 · 2012: 23
- FWCI
- 26.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- 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
- irritable bowel syndrome, FODMAPs, short-chain carbohydrates, breath hydrogen, breath methane, low FODMAP diet, gastrointestinal symptoms, flatus, dietary intervention
- MeSH terms
- Adult, Aged, Breath Tests, Dietary Carbohydrates, Female, Fermentation, Flatulence, Humans, Hydrogen, Intestinal Mucosa, Intestines, Male, Methane, Middle Aged, Time Factors, Victoria, Abdominal Pain, Diet Records, Single-Blind Method, Treatment Outcome, Cross-Over Studies, Irritable Bowel Syndrome, Exhalation, Diet, Carbohydrate-Restricted, Lethargy, Young Adult
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