Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome

Ong, Derrick K., Mitchell, Shaylyn B., Barrett, Jacqueline S., Shepherd, Sue J., Irving, Peter M., Biesiekierski, Jessica R., Smith, Stuart, Gibson, Peter R. and Muir, Jane G. 2010, Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome, Journal of gastroenterology and hepatology, vol. 25, no. 8, pp. 1366-1373, doi: 10.1111/j.1440-1746.2010.06370.x.

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Title Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome
Author(s) Ong, Derrick K.
Mitchell, Shaylyn B.
Barrett, Jacqueline S.
Shepherd, Sue J.
Irving, Peter M.
Biesiekierski, Jessica R.
Smith, Stuart
Gibson, Peter R.
Muir, Jane G.
Journal name Journal of gastroenterology and hepatology
Volume number 25
Issue number 8
Start page 1366
End page 1373
Total pages 8
Publisher Blackwell Publishing Asia Pty Ltd
Place of publication Richmond, Vic.
Publication date 2010-08
ISSN 0815-9319
Keyword(s) breath testing
dietary therapy
gastrointestinal symptoms
irritable bowel syndrome
Summary 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.
Notes Article first published online 14 May 2010
Language eng
DOI 10.1111/j.1440-1746.2010.06370.x
Field of Research 110307 Gastroenterology and Hepatology
Socio Economic Objective 920105 Digestive System Disorders
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2010, Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
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Collections: Faculty of Health
School of Exercise and Nutrition Sciences
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