Abstract

Irritable bowel syndrome (IBS) is a common condition that can have a significant impact on a person's quality of life.¹ The cause of IBS is unknown but several mechanisms have been proposed including visceral hypersensitivity, central sensitisation, abnormal gut motility and altered gut microbiota.^2,3 IBS is challenging to manage and many patients report insufficient symptomatic relief from treatment.² Approximately 60% of patients identify food as a trigger for their symptoms,² and there has been interest in exclusion diets for managing IBS.⁴ Dietary adaptation is a common self-management strategy for patients with IBS, with many self-diagnosing intolerance to specific foods. This may lead to patients adopting over-restrictive or inappropriate diets.⁵

In recent years, a diet low in poorly absorbed short-chain carbohydrates, known collectively as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), has been advocated for the treatment of IBS.² Here, we discuss the background to the FODMAP diet and review the evidence supporting its use for people with IBS.