CC January 2015 Irritable bowel syndrome and FODMAPs diet

echoecho's version from 2015-05-20 13:43


Question Answer
Define IBS?irritable bowel syndrome is a crhonic functional bowel disorder characterized by abdominal pain, bloating, constipaton and /or diarrhea
What % of the adolescent and adult population have IBS?10-15%
Despite its prevalence, effective treatment is often difficult and good studies are lacking, true or false?true
Historically, what was the dietary interventions?increased fiber diet, fluids, avoidance of gas-producing foods
Studies have demonstrated that increased fiber diet, fluids and avoidance of gas- producing foods have little or no effect, true or false?true
A recent systematic review of ____ fiber supplementation di find some benefit but the number needed to treat was 7?soluble
A trial of soluble fiber is a reasonable option, why?since a small percentage of people may benefit and the adverse effects and costs are low
Recent studies have shown benefit of diets low in what?low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs)
What are FODMAPs?short-chain carbohydrates (sugars) that are osmotic in the gut may not be well digested or absorbed and therfore can be fermented int he GI tract, producing s/s of gas, bloating, pain and altered bowel patterns
Define fermentable?degradation of undigested carbohydrates by gut bacteria produces gas (methane, hydrogen, carbon dioxide)
Define Oligosaccharides?fructo-oligosaccharides (wheat, rye, onions, garlic); galacto-oligosaccharides (legumes)
Define disaccharides?lactose (milk, yogurt, soft cheese)
Define monosaccharides?fructose (in excess of glucose - honey, apples, high-fructose corn syrup)
Define polyols?sorbitol, mannitol (some fruits and vegetables)
*** A number of studies show the benefit of FODMAPs restricted diet for IBS, although only a few small studies are randomized and controlled. All studies (4 weeks to 16 months) found FODMAP restriction was associated with significant improvement in IbS symptoms in about ____% of patients?70%
***Dietary changes limiting ______ is reasonable and considered first-line therapy for IBS?FODMAPs
List the disadvantages of the FODMAPs restriction?1) initiating and maintaining this diet is difficult and requires reading of labels and managing portions 2) maintaining this diet over long periods of time may be associated with nutritional deficiencies 3) changes in luminal bifidobateria are noted 4) long-term effects of luminal bifidobacteria are not known
While gluten (found in wheat, barley and rye) and lactose-containing foods are high in ______ and ______, respectively, there is no evidence that elimination of these foods alone is sufficient as a dietary intervention for IBS?oligosaccharides, and disaccharides
Avoidance of gluten is useful for what diesease state?gluten-enteropathy and lactose intolerance (lactase deficiency)
An ______ trial would be a consideration for pts who fail the FODMAPs diet?elimination