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World J Clin Cases. Sep 26, 2019; 7(18): 2666-2674
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2666
Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet in children
Ioana Fodor, Sorin Claudiu Man, Dan L Dumitrascu
Ioana Fodor, Sorin Claudiu Man, 3rd Pediatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 400006, Romania
Dan L Dumitrascu, 2nd Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 400006, Romania
Author contributions: Fodor I performed the literature research, analyzed the data, and wrote the paper; Man SC analyzed the data and corrected the manuscript; Dumitrascu DL designed the literature research, analyzed the data, and corrected the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Dan L Dumitrascu, PhD, Full Professor, Internal Medicine Professor, 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Clinicilor Street nr3-5, Cluj-Napoca 400006, Romania. dan_dumitrascu@yahoo.de
Telephone: +40-722-756475 Fax: +40-264-593355
Received: April 19, 2019
Peer-review started: April 19, 2019
First decision: July 10, 2019
Revised: July 26, 2019
Accepted: August 27, 2019
Article in press: August 26, 2019
Published online: September 26, 2019
Abstract

Irritable bowel syndrome (IBS) is a lifelong condition with a high prevalence among children and adults. As the diet is a frequent factor that triggers the symptoms, it has been assumed that by avoiding the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP), the symptoms might be improved. Therefore, in the past decade, low FODMAP diet has been intensively investigated in the management of IBS. The capacity of FODMAPs to trigger the symptoms in patients with IBS was related to the stimulation of mechanoreceptors in the small and large intestine. This stimulation appears as a response to a combination of increased luminal water (the osmotic effect) and the release of gases (carbon dioxide and hydrogen) due to the fermentation of oligosaccharides and malabsorption of fructose, lactose and polyols. Numerous studies have been published regarding the efficacy of a low FODMAP diet compared to a traditional diet in releasing the IBS symptoms in adults, but there are only a few studies in the juvenile population. The aim of this review is to analyze the current data on both low FODMAP diet in children with IBS and the effects on their nutritional status and physiological development, given the fact that it is a restrictive diet.

Keywords: Low fermentable oligosaccharides, Disaccharides, Monosaccharides, Polyols, Diet, Children, Irritable bowel syndrome, Symptom

Core tip: Irritable bowel syndrome is one of the most studied entities among the functional gastrointestinal disorders. The relationship between fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) and gastrointestinal symptoms was demonstrated both in adults and children. Published studies showed that a low-FODMAP diet is effective for the management of abdominal pain and bloating sensations in most children and adults with irritable bowel syndrome. The children’s nutritional status during a long time restrictive FODMAP diet is not sufficiently assessed.