A salutogenic approach to managing Irritable Bowel Syndrome: exploring the efficacy of the FODMAP diet to revive IBS-patients’ Quality of Life

Irritable bowel syndrome (IBS) is a commonly diagnosed gastrointestinal disorder that can have a substantial impact on quality of life. Most IBS-patients associate their gastrointestinal symptoms with eating
food, hence dietary interventions are considered important to the treatment and control of IBS. The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet is currently the most evidence-based dietary therapy and intervention for IBS. The Low-FODMAP diet as a personalized precision-nutrition dietary therapy offers potential for IBS patients’ symptoms improvement and enhancement of quality of life.

IBS, LOW-FODMAP diet and Quality of Life IBS is a multifactorial, heterogeneous, debilitating, complex, chronic disorder of heterogeneous pathogenesis and clinical phenotype, and the most prevalent Functional Gastrointestinal Disorders (FGIDs). Foods are considered as possible etiopathogenetic or exacerbating factors of IBS. Hence, an increasing number of IBS-patients have attempted dietary therapy for the treatment and control of GI-symptoms and for enhancing their quality of life (QOL). The LOW-FODMAP diet (LFD) is a novel, adjuvant dietary therapy for IBS for the treatment of IBS. The purpose of this paper is to explicate how the FODMAP-diet is implemented, and to examine and discuss the efficacy of the FODMAP-diet in the treatment and control of IBS-symptoms and impact on QOL. The scientific evidence from a range of retrospective, prospective, uncontrolled and controlled observational cohort studies and clinical trials from multiple centres around the world demonstrate the clinical efficacy and putative mechanisms of the LFD as a dietary therapy for improvement of GI-symptoms and QOL.

We contend that a ‘Salutogenic1 integrative, holistic, patient-centred approach to the treatment of IBS by applying the LFD as personalized precision-nutrition therapy, provides IBS-patients direction towards GI-symptoms control and QOL. Further research is pertinent to fill current gaps in knowledge on the effects of the LFD on GI-symptoms type, severity and frequency, nutritional adequacy, altered gut microbiota composition, colonic health and QOL. This will allow for making robust inferences about the long-term risk and safety of the LFD for IBS-patients.

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