FODMAP은 diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs)입니다.
이것은 가스를 만드는 음식을 배제하였으에도 불구하고 복부 팽만감 또는 통증이 있는 IBS 환자에서 제안되는 식사 요법입니다.
Characteristics and sources of common FODMAPs
|
|
Word that corresponds to letter in acronym |
Compounds in this category |
Foods that contain these compounds |
|
F |
Fermentable |
||
|
O |
Oligosaccharides |
Fructans, galacto-oligosaccharides |
Wheat, barley, rye, onion, leek, white part of spring onion, garlic, shallots, artichokes, beetroot, fennel, peas, chicory, pistachio, cashews, legumes, lentils, and chickpeas |
|
D |
Disaccharides |
Lactose |
Milk, custard, ice cream, and yogurt |
|
M |
Monosaccharides |
"Free fructose" (fructose in excess of glucose) |
Apples, pears, mangoes, cherries, watermelon, asparagus, sugar snap peas, honey, high-fructose corn syrup |
|
A |
And |
||
|
P |
Polyols |
Sorbitol, mannitol, maltitol, and xylitol |
Apples, pears, apricots, cherries, nectarines, peaches, plums, watermelon, mushrooms, cauliflower, artificially sweetened chewing gum and confectionery |
FODMAPs: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Adapted by permission from Macmillan Publishers Ltd: American Journal of Gastroenterology. Shepherd SJ, Lomer MC, Gibson PR. Short-chain carbohydrates and functional gastrointestinal disorders. Am J Gastroenterol 2013; 108:707. Copyright © 2013. www.nature.com/ajg.
이 단쇄 탄수화물(short-chain carbohydrates)은 흡수가 잘 되지 않으며 장 내강에서 빠르게 발효되어 삼투압 작용을 하며 결과적으로 복부 팽만감과 통증을 유발합니다. Low FODMAP education은 처음에 6-8 주 동안 식이에서 FODMAP을 제거한 다음 증상 호전 이후 발효 탄수화물이 높은 음식을 점진적으로 재투여하여 특정 발효 탄수화물에 대한 개인의 tolerance를 결정합니다.
연구들에서 FODMAP 제한으로 IBS 증상 개선을 입증하였습니다.
In a randomized, single-blind, crossover trial, 30 patients with IBS and 8 healthy controls were assigned to 21 days of a diet low in FODMAPs or a moderate FODMAP Australian diet followed by a 21-day washout period before crossing over to an alternate diet. Subjects with IBS, but not controls, had significantly lower overall gastrointestinal symptoms scores with an improvement in scores for abdominal pain, bloating, flatulence, and dissatisfaction with stool consistency while on a low FODMAP diet as compared with the moderate FODMAP diet and their diet at baseline.
In another randomized trial 92 patients with IBS-D were assigned to a four week trial of a low FODMAP diet or modified National Institute for Health and Care Excellence dietary recommendations (small frequent meals, avoid trigger foods, and avoid excess alcohol and caffeine). There was no significant difference in the proportion of patients reporting adequate relief of IBS-D. However, the low FODMAP group exhibited significantly higher rates of improvement in pain (51 versus 23 percent) and greater reductions in average daily scores for abdominal pain, bloating, stool consistency, frequency, and urgency.
REF. UpToDate 2019.12.22
