Poorly absorbed carbohydrates (PAC): A case control study between Irritable Bowel Syndrome patients and healthy volunteers

1st October 2015 - ongoing

Status: Active

Specialism: Lower GI.

Team: Professor Robin Spiller.

Fermentable Oligo-di-monosaccharide and Polyols (FODMAP) is a group of poorly absorbed, short-chain carbohydrates that has been found to trigger gastrointestinal symptoms in Irritable Bowel Syndrome patients. They are comprised of free fructose, lactose, oligosaccharides and polyols. FODMAPs are highly osmotic, poorly absorbed and undergo rapid fermentation in the large intestine to produce hydrogen, carbon dioxide, and short chain fatty acids. As a result, this induces functional gut symptoms such as diarrhoea, bloating and abdominal discomfort. Due to the combined effect of FODMAPs on functional gut symptoms, dietary intervention is initially targeted at lowering the amount of FODMAPs, followed by gradual reintroduction into the diet to avoid excluding foods which do not provoke symptoms. In addition, the low FODMAP diet has been successful in reducing symptoms in IBS patients as demonstrated by several randomised controlled trials.

Current population studies involving IBS patients and healthy volunteers have measured macronutrient and micronutrient content of the diet. Meanwhile, other studies have focused on the dietary perceptions and food avoidance between these groups to alleviate gastrointestinal symptoms. These initial investigations were useful as they probed into the dietary habits of IBS patients. However, due to poor study design and dietary assessment methods, the results are debatable in showing a difference in intake between two groups as well as self-reported food intolerance. Additionally, there was no attempt to measure FODMAP intakes in these studies. A recent study in the United Kingdom did measure FODMAP intake in IBS patients taking a habitual diet. However, there is no recent data on average FODMAP intake in IBS patients compared to that of a healthy population.

Therefore our primary aim is to assess dietary FODMAP intake and compare it between Irritable Bowel Syndrome patients and healthy volunteers. Our secondary aim is to compare perceived self-reported food intolerance with actual intake and symptoms.

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professor-robin-spiller Professor Robin Spiller Robin's main interest is in the pathophysiology of functional GI diseases, particularly focusing on the role of infection and inflammation and alterations in serotonin metabolism in the irritable bowel syndrome. He has twice edited the British Society of…
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