Functional gastrointestinal disorders are chronic diseases including irritable bowel syndrome (IBS), functional constipation, functional diarrhea, functional bloated stomach or swelling, among other not specified ailments. Patients who present these conditions are diagnosed with a functional gastrointestinal disorder (FGD). The IBS is the most frequent affecting almost fifteen per cent of the Mexican population.

To treat this condition, relevant studies show the restriction of certain foods can improve the symptoms of those who suffer from a FGD. There has been special attention to the restriction of fermentable short-chain carbohydrates; this diet has been called FODMAP–Low Fermentable Oligo, Di, Monosaccharides and Polyol.

This restriction consists of reducing to the extent possible the intake of foods rich in fructans, galactooligosaccharides, galactans, lactose, fructose and polyols–carbohydrates ferment in the colon and are responsible for the alterations which patients usually suffer.

Fructans are naturally found in products like wheat and onion, as well as in those with added fructose as to improve their texture and flavor. Galactooligosaccharides are present in milk and dairy products, legumes, and some nuts and seeds.

Fructose and lactose are examples of monosaccharides and disaccharides respectively, and they are found in fruits and their byproducts, marinated meat, and products in which fructose is used as an additive such as bakery and confectionery products.

Polyols–like sorbitol, xylitol, and mannitol–are naturally present in apples, pears, plums, and mushrooms; they are also employed as no calorie sweeteners in products like chewing gum and sugar free candy.

In addition, there are the long-chain polysaccharides which ferment at a lower level and are considered insoluble fiber. Some of the most important components of these polysaccharides are cellulose, hemicellulose, pectin, and resistant starches. The latter can appear in reheated dough, since it would change the structure of starch making it less susceptible of digestion and, consequently, of fermentation in the gut microbiota.

Polysaccharides are also present in wholegrain cereals, chestnuts, plums, pears, apples, and legumes. What matters the most is that these carbohydrates have a selective impact on the development of desirable microorganisms–that is why they are also known as prebiotics. Prebiotics might be beneficial in the long run for patients with diseases related to FGD, as long as the effect for each case has been identified.

Supervision provided by health professionals will prevent the exclusion of a beneficial food from the patient’s diet and, if necessary, help finding alternatives which do not alter nutrient intake or compromise micronutrient absorption. 

Relevant studies consider the intake of certain foods as “safe”, foods that can become part of a FGD patient’s diet without worsening any symptom. In the same way, as previously mentioned, said studies suggest a moderate intake or the reduction of some foods when they have been observed to aggravate digestive discomfort. 

Take a look at the following chart:

FODMAP diet could make easier the identification of the foods triggering FGD symptoms. The main objective is to find a long-term balance between foods triggering negative effects and those improving symptoms once intake restrictions have been put into place.

Nowadays, the composition of a large number of products have been modified having people with these ailments in mind. Therefore, consumers can learn about FODMAP content by reading product labels.

As to have a personal analysis of the effects each food has and the amounts that trigger symptoms associated with FGD, patients would have to be accompanied by an expert. Additionally, patients can seek guidance on new recipes and cooking techniques which help them find alternatives in order to reduce digestive syndromes.

Writen by Mónica Basave