Low FODMAPs and gluten-free foods for irritable bowel syndrome treatment: Lights and shadows

Irritable bowel syndrome (IBS) is a functional bowel disorder with a global prevalence of 10-20% and in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. IBS strongly impairs quality of life, social function, work productivity, and brings substantial costs to health care services. The etiology of IBS remains poorly understood and the search for biomarkers is ongoing. Bloating, distension, and disordered defecation are commonly associated features. The role of dietary components in inducing IBS symptoms is difficult to explore. To date, foods are not generally considered a cause but rather symptom triggering factors, and are a significant component of the management pathway for many individuals. The use of functional foods in the management of IBS has been limited to dairy products, with particular interest in the use of probiotics. Particular interest has been given to gluten-free and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol (FODMAP) approach to treatment of IBS. There is scope to modify some of the existing products in the cereal market, in such a way that they would then comply with the gluten-free/low FODMAP diet. This modification could then in turn, help individual patients to experience a beneficial reduction in the symptoms of IBS. This literature review is intended to provide a discussion on the diet disease link between IBS and gluten-free/low FODMAP diet, for the purpose of creating an academic foundation on which to develop functional foods, suitable for patients with IBS.