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Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome?

1
Gastrointestinal Unit–Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy
2
Clinical and Experimental Medicine–Rheumatology Unit, University of Pisa, 56100 Pisa, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(11), 3368; https://doi.org/10.3390/nu12113368
Received: 16 September 2020 / Revised: 22 October 2020 / Accepted: 29 October 2020 / Published: 1 November 2020
(This article belongs to the Special Issue Advance in Gluten-Free Diet)
Irritable Bowel Syndrome (IBS) is a very common functional gastrointestinal disease. Its pathogenesis is multifactorial and not yet clearly defined, and hence, its therapy mainly relies on symptomatic treatments. Changes in lifestyle and dietary behavior are usually the first step, but unfortunately, there is little high-quality scientific evidence regarding a dietary approach. This is due to the difficulty in setting up randomized double-blind controlled trials which objectively evaluate efficacy without the risk of a placebo effect. However, a Low Fermentable Oligo-, Di- and Mono-saccharides And Polyols (FODMAP) Diet (LFD) and Gluten Free Diet (GFD) are among the most frequently suggested diets. This paper aims to evaluate their possible role in IBS management. A GFD is less restrictive and easier to implement in everyday life and can be suggested for patients who clearly recognize gluten as a trigger of their symptoms. An LFD, being more restrictive and less easy to learn and to follow, needs the close supervision of a skilled nutritionist and should be reserved for patients who recognize that the trigger of their symptoms is not, or not only, gluten. Even if the evidence is of very low-quality for both diets, the LFD is the most effective among the dietary interventions suggested for treating IBS, and it is included in the most updated guidelines. View Full-Text
Keywords: irritable bowel disease; FODMAP; low FODMAP diet; gluten free diet; non-celiac gluten wheat sensitivity irritable bowel disease; FODMAP; low FODMAP diet; gluten free diet; non-celiac gluten wheat sensitivity
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MDPI and ACS Style

Bellini, M.; Tonarelli, S.; Mumolo, M.G.; Bronzini, F.; Pancetti, A.; Bertani, L.; Costa, F.; Ricchiuti, A.; de Bortoli, N.; Marchi, S.; Rossi, A. Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome? Nutrients 2020, 12, 3368. https://doi.org/10.3390/nu12113368

AMA Style

Bellini M, Tonarelli S, Mumolo MG, Bronzini F, Pancetti A, Bertani L, Costa F, Ricchiuti A, de Bortoli N, Marchi S, Rossi A. Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome? Nutrients. 2020; 12(11):3368. https://doi.org/10.3390/nu12113368

Chicago/Turabian Style

Bellini, Massimo; Tonarelli, Sara; Mumolo, Maria G.; Bronzini, Francesco; Pancetti, Andrea; Bertani, Lorenzo; Costa, Francesco; Ricchiuti, Angelo; de Bortoli, Nicola; Marchi, Santino; Rossi, Alessandra. 2020. "Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome?" Nutrients 12, no. 11: 3368. https://doi.org/10.3390/nu12113368

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