Fodmaps Presentation For Website

FSHN 329 Final Presentation
DNS Divas
Lauren Killian, Natalie Masis, Morgan Curran, Erin Davis
Learning Objectives
1.Identify what the acronym FODMAP stands for
2.Name two physiological effects of FODMAPs in those with
FGIDs
3.List two ways that dietitians can help clients to manage
their IBS
Background
Functional Gastrointestinal Disorders (FGID)
Symptoms are common, hard to manage, often triggered by food

Pharmaceutical therapies offer only mild relief
Interfere with quality of life and work productivity
Irritable Bowel Syndrome (IBS)
Most commonly diagnosed GI condition (12% of N. American pop.)

Symptoms:
altered bowel habits
abdominal pain
bloating and excess gas
Pathophysiology
Environment: antibiotics, food intolerance, stressors, infection
Host: dysbiosis; altered gut-brain activity, intestinal permeability,
gut immune activation; increased visceral sensation
50-75% of people with IBS associate symptoms with food
https://www.foodnotmeds.com/irritable-bowel-syndrome-affects-20-ofthe-population-primarily-women/
Needs Assessment (IBS)

Women > Men
Prevalence decreases with age
Per year:
3.1 million ambulatory care visits
5.9 million prescriptions
> $20 billion in related healthcare costs
Up to 90% restrict their diet
What are FODMAPs?

Fermentable
Oligosaccharides
(fructans/galactans)
Disaccharides (lactose)
Monosaccharides
(fructose)
And
Source: Food intolerance management plan by Dr. Sue Shepherd and Dr. Peter Gibson
Polyols
(sugar alcohols)
Characteristics and
Physiological
Effects
Short-chain carbohydrates that are:
Poorly absorbed
Osmotically active
Rapidly fermentable
Effects lead to luminal distention:
Diarrhea and/or constipation

Gas
Bloating
Pain
Altered bowel movements
Shepard et al.., Am J Gastroenterol. (2013)
Note: FODMAPs do not cause GI disorders; however, they can exacerbate symptoms
iClicker Question 1
What does FODMAP stand for?
A.Friendly Oligosaccharides Disaccharides Monosaccharides
and Polyols
B.Fermentable Oligosaccharides Disaccharides
Monosaccharides and Polyols
C.Fruits, oats, donuts, muffins, agave, pasta
D.Facilitative Oligosaccharides Disaccharides
Monosaccharides and Polyols
iClicker Question 2
Which of the following can be classified in the monosaccharide
category?
A.Apples, Asparagus, Bread
B.Mannitol, Xylitol
C.Honey, Corn Syrup
D.Yogurt, Cheese, Ice Cream
Literature Review on FODMAPs

Building evidence for short-chain carbohydrates and IBS
symptoms
Hypothesis paper in 2005 from Australia
Adult IBS
1 double blind placebo-controlled rechallenge study

3 randomized controlled trials
Many uncontrolled trials
Challenge studies, observational, comparative
Success with FODMAPs

Proof of mechanism
Poorly absorbed, osmotically
active, rapidly fermented
Success in up to 75% of
patients
Superior to current UK best
practice for IBS
jazztruth.blogspot.com
Currently applying to other

populations
Pediatric IBS
Inflammatory Bowel Diseases
Ileostomy/ileal pouch
Enteral nutrition
Chronic disease states
Athletes?
Additional Australian Contribution

Analyze FODMAP content of foods
High-performance liquid chromatography and enzymatic assays
Develop database
Monash University Low FODMAP Diet App
FODMAP-specific dietary analysis
Complete Nutritional Assessment Questionnaire
Low FODMAP Certification Program

http://www.med.monash.edu/cecs/gastro/fodmap/iphone-app.html
Methods & Results

FODMAPS in Treating IBS
http://www.mensanswer.com/wp-content/uploads/2015/06/ibssymptoms.jpg
Patients with diagnosed IBS

Control patients healthy with no
gastrointestinal symptoms
No previous visits with a dietitian
All meals and snacks provided for 21 days on
each intervention
http://img.medscape.com/thumbnail_library/dt_150527
_irritable_bowel_stomach_pain_800x600.jpg
Fecal assessment with frequency, weight, and

water content
Methods & Results

FODMAPS in Treating IBS
Methods & Results

FODMAPS in Treating
IBS
Overall gastrointestinal
symptoms were less in the
low FODMAP diet
Similar results were seen in
abdominal pain, bloating,
and passage of wind
Improvement was
statistically significant
(P<0.001) in 70% of the
participants
iClicker Question 3
Which of the following are major symptoms of IBS?
A.Abdominal pain, cramps, bloating, gas
B.Fever, chills, runny nose, congestion
C.Fatigue, headache, skin rash, sore throat
D.Vomiting, indigestion, fever, muscle weakness
Conclusions
Foods trigger FGID and IBS symptoms
Low FODMAP diet can decrease symptoms
FODMAP carbs are poorly absorbed
Helpful to have more one-on-one direction

More specialized training needed
Success with FODMAPS: further research
Future directions
Long-term, larger studies
Nutrient deficiencies with restriction
Other populations
Complementary and alternative medicine treatments
US Foods
Impact of the FODMAP restriction on GI microbiota
May affect diversity/composition of the microbiota
Clinical Practice Recommendations

FODMAPS can be an option for IBD patients to lessen
severity of symptoms
Clinical, routine approach
Restriction is not long-term goal

Technology use
FODMAPs app - effective?
RD-specific training
References
1.
Barrett JS, Gearry RB, Muir JG, Irving PM, Rose R, Rosella O, Haines ML, Shepherd SJ, Gibson PR. Dietary poorly
absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon.
Aliment Pharmacol Ther. 2010;31:874882.
2.
Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and
nonallergic food intolerance: FODMAPs or food chemicals? Therap Adv Gastroenterol. 2012; 5(4): 261-268.
3.
Chey WD. Food: The Main Course to Wellness and Illness in Patients With Irritable Bowel Syndrome. Am J
Gastroenterol. 2016;111:366371.
4.
Chey WD, Kurlander J, Eswaran S. Irritable Bowel Syndrome: A Clinical Review. JAMA. 2015; 313(9): 949-958.
5.
Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The
FODMAP approach. J Gastroen Hepatol. 2010;25:252-258.
6.
Gibson PR, Shepherd SJ. Food Choice as a Key Management Strategy for Functional Gastrointestinal Symptoms.
Am J Gastroentero. 2012;107: 657-666.
7.
Halmos, Emma P., Victoria A. Power, Susan J. Shepherd, Peter R. Gibson, and Jane G. Muir. "A Diet Low in FODMAPs
Reduces Symptoms of Irritable Bowel Syndrome."Gastroenterology 146.1 (2014): 67-75. Print.
8.
King K, Chumpitazi B. FODMAPS: Navigating the Novel Diet in the Pediatric Populations. Food & Nutrition
Conference & Expo. 2015.
9.
Langhorst, J., Wulfert, H., Lauche, R., Klose, P., Cramer, H., Dobos, G. J., & Korzenik, J. (2015). Systematic review
of complementary and alternative medicine treatments in inflammatory bowel diseases. Journal of Crohn's and
Colitis, 9(1): 86-106.

Fodmaps Presentation For Website

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Fodmaps Presentation For Website

Uploaded by

Copyright:

Available Formats

FSHN 329 Final Presentation

Functional Gastrointestinal Disorders (FGID)

Symptoms are common, hard to manage, often triggered by food

Irritable Bowel Syndrome (IBS)

Most commonly diagnosed GI condition (12% of N. American pop.)

Needs Assessment (IBS)

Up to 90% restrict their diet

What are FODMAPs?

Effects lead to luminal distention:

Diarrhea and/or constipation

Literature Review on FODMAPs

1 double blind placebo-controlled rechallenge study

Success with FODMAPs

Currently applying to other

Additional Australian Contribution

Low FODMAP Certification Program

Methods & Results

Patients with diagnosed IBS

Fecal assessment with frequency, weight, and

Methods & Results

Methods & Results

Helpful to have more one-on-one direction

Success with FODMAPS: further research

Clinical Practice Recommendations

Restriction is not long-term goal

You might also like