Food intolerance in functional bowel disorders
Abstract
Background and Aim: Food‐related symptoms are commonly described by patients with functional bowel disorders, but dietary change as an evidence‐based therapy has not been part of routine management strategies. This reviews aims to discuss strategies commonly applied. Method: Published literature was reviewed. Results: Traditional approaches involve elimination diets followed by placebo‐controlled reintroduction of specific foods, which is tedious at best and not applied in routine practice. Pathogenically‐based approaches include determining what food components are inducing food hypersensitivity responses using specific biomarkers, but this is probably applicable to a small proportion of patients only and has met with only limited success. Food bioactive chemicals, such as salicylates, have been targeted, but there is a paucity of quality evidence for or against this approach. In contrast, targeting poorly absorbed dietary components that might induce luminal distension via osmotic effects and rapid fermentation (FODMAPs) has been successful and the efficacy of the dietitian‐delivered low FODMAP diet is now supported by high quality evidence. Improvement of all symptoms of FBD in three out of four patients has been achieved. The diet may potentially improve stool frequency in patients with an ileal pouch or a high output ileostomy, or functional symptoms in patients with inflammatory bowel disease. FODMAPs in enteral formulas may also be responsible for diarrhoea induced by enteral nutrition. Conclusion: Dietary restriction of FODMAPs is an effective therapy in the majority of patients with functional bowel symptoms and, provided dietitians are trained in the technique, should be first line therapy.
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The majority of IBS patients believe that their IBS symptoms are initiated or worsened by certain foods, and many report intolerance to a variety of foods.
“The majority of IBS patients believe that their IBS symptoms are initiated or worsened by certain foods and many of them report intolerance (i.e., hypersensitivity) to a variety of foods (68).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [68]
Cites
Evidence‐based dietary management of functional gastrointestinal symptoms: The FODMAP approach
Gibson, P. R., & Shepherd, S. (2009) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2009.06149.x · Cited by 657 · see citing works
Self-citationReview article: prebiotics in the gastrointestinal tract
Macfarlane, S., Macfarlane, G. T., & Cummings, J. H. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03042.x · Cited by 624 · see citing works
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. (2010) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2010.06370.x · Cited by 583 · see citing works
Self-citationShepherd, S. J., Parker, F. C., Muir, J. G., & Gibson, P. R. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.02.058 · Cited by 549 · see citing works
Self-citationFood elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial
Atkinson, W., Sheldon, T. A., Shaath, N., & Whorwell, P. J. (2004) · Gut · doi:10.1136/gut.2003.037697 · Cited by 534 · see citing works
Shepherd, S. J., & Gibson, P. R. (2006) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2006.07.010 · Cited by 408 · see citing works
Self-citationBarrett, J. S., Gearry, R. B., Muir, J. G., Irving, P. M., ROSE, R., Rosella, O., Haines, M. L., Shepherd, S., & Gibson, P. G. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04237.x · Cited by 403 · see citing works
Self-citationGibson, P. R., & Shepherd, S. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02506.x · Cited by 391 · see citing works
Self-citationMuir, J. G., Rose, R., Rosella, O., Liels, K., Barrett, J. S., Shepherd, S., & Gibson, P. R. (2009) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf802700e · Cited by 331 · see citing works
Self-citationGearry, R. B., Irving, P. M., Barrett, J. S., Nathan, D. M., Shepherd, S. J., & Gibson, P. R. (2008) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2008.09.004 · Cited by 323 · see citing works
Self-citationFructan and Free Fructose Content of Common Australian Vegetables and Fruit
Muir, J. G., Shepherd, S., Rosella, O., Rose, R., Barrett, J. S., & Gibson, P. R. (2007) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf070623x · Cited by 288 · see citing works
Self-citationReview article: fructose malabsorption and the bigger picture
GIBSON, P. R., Newnham, E., Barrett, J. S., Shepherd, S., & Muir, J. G. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03186.x · Cited by 256 · see citing works
Self-citationBarrett, J. S., Irving, P. M., Shepherd, S., Muir, J. G., & GIBSON, P. R. (2009) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2009.04018.x · Cited by 159 · see citing works
Self-citationAre adverse food reactions linked to irritable bowel syndrome?
Niec, A., Frankum, B. S., & Talley, N. J. (1998) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1998.00531.x · Cited by 158 · see citing works
Bischoff, S. C., Mayer, J. H., Wedemeyer, J., et al. (1997) · Gut · doi:10.1136/gut.40.6.745 · Cited by 157 · see citing works
Croagh, C. M. N., Shepherd, S., Berryman, M., Muir, J. G., & Gibson, P. R. (2007) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20249 · Cited by 100 · see citing works
Self-citationSeeking Control Through the Determination of Diet
JAMIESON, A. E., Fletcher, P. C., & Schneider, M. A. (2007) · Clinical Nurse Specialist · doi:10.1097/01.nur.0000270015.97457.9c · Cited by 78 · see citing works
A Cytologic Assay for Diagnosis of Food Hypersensitivity in Patients With Irritable Bowel Syndrome
Carroccio, A., Brusca, I., Mansueto, P., Pirrone, G., Barrale, M., Di Prima, L., Ambrosiano, G., Iacono, G., Lospalluti, M. L., La Chiusa, S. M., et al. (2010) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.11.010 · Cited by 71 · see citing works
Irritable bowel syndrome - An inflammatory disease involving mast cells
Philpott, H., Gibson, P. G., & Thien, F. C. K. (2011) · Asia Pacific Allergy · doi:10.5415/apallergy.2011.1.1.36 · Cited by 70 · see citing works
Self-citationHalmos, E. P., Muir, J. G., Barrett, J. S., Deng, M., Shepherd, S., & Gibson, P. G. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04416.x · Cited by 63 · see citing works
Self-citationSignificance of salicylate intolerance in diseases of the lower gastrointestinal tract.
Raithel, M., Baenkler, H.-W., Naegel, A., et al. (2005) · PubMed · Cited by 58 · see citing works
Neri, M., Laterza, F., Howell, S. C., Gioacchino, M. D., Festi, D., Ballone, E., Cuccurullo, F., & Talley, N. J. (2000) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-200012090-00003 · Cited by 28 · see citing works
Lied, G. A., Lillestøl, K., Valeur, J., & Berstad, A. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04314.x · Cited by 27 · see citing works
Atopic irritable bowel syndrome: same old hat or a new entity?
Tobin, M. C., Keshavazian, A., & Farhardi, A. (2008) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2.4.457 · Cited by 6 · see citing works
(1984) · The Lancet · doi:10.1016/s0140-6736(84)91353-9 · Cited by 5 · see citing works
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Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome
Ringel, Y., & Maharshak, N. (2013) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00207.2012 · Cited by 115 · see citing works
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El-Salhy, M. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i25.7621 · Cited by 111 · see citing works
Functional bowel symptoms, fibromyalgia and fatigue: A food-induced triad?
Berstad, A., Undseth, R., Lind, R., & Valeur, J. (2012) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365521.2012.690045 · Cited by 49 · see citing works
- Authors
- Gibson, P. R.
- Affiliations
- Eastern Health (AU)
- Corresponding author
- Gibson, Peter R
- Venue
- Journal of Gastroenterology and Hepatology
- Publisher
- Wiley
- Published
- 2011-03-28
- Volume
- 26
- Issue
- s3
- Pages
- 128-131
- ISSN
- 0815-9319 (ISSN-L)
- 1440-1746
- OpenAlex
- W2100645738
- Cited by
- 71
- References
- 25
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 10 · 2016: 7 · 2015: 8 · 2014: 8 · 2013: 9 · 2012: 8
- FWCI
- 8.52
- 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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- food intolerance, functional bowel disorders, FODMAPs, low FODMAP diet, elimination diet, salicylates, dietary therapy, ileal pouch, high-output ileostomy, inflammatory bowel disease
- MeSH terms
- Diet, Food Hypersensitivity, Humans, Treatment Outcome, Patient Selection, Evidence-Based Medicine, Irritable Bowel Syndrome
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