FODMAP Diet and Its Applied Diseases

Yıl 2024, Cilt: 3 Sayı: 2, 136 - 148, 31.08.2024

Tuğba Tatar , Funda Akgül

https://doi.org/10.59778/sbfdergisi.1475334

Öz

Fermented oligosaccharide, disaccharide monosaccharide, and polyols refer to FODMAP. FODMAP carbohydrates are generally rich in fruit and vegetable. They have poor absorption but high osmotic properties. They cause bloating and gas by fermenting in colon. So, nutritional therapy is applied in some diseases by gradually removing FODMAP from the diet. Diseases in which FODMAP diet is applied: irritable bowel syndrome (IBS), inflammatory bowel diseases (IBD), and non-celiac gluten sensitivity (NCGS). IBS is a gastrointestinal system disease characterized by abdominal pain, bloating, and reduction of pain due to defecation. IBD is a chronic and recurrent disease occuring due to inflammation in the intestinal mucosa. Although constipation is observed in some patients initially, it usually progresses with diarrhea. NCGS gives symptoms similar to IBS but does not meet the diagnostic criteria of celiac disease or wheat allergy. With the elimination of gluten, symptoms improve. The basis of the nutritional treatment of these diseases is removing disturbing food from the diet since some foods cause discomfort after consumption. Similarly, in these diet, foods rich in fermented oligosaccharides, fructans, raffinose, inulin, lactose, sucrose, fructose and poliols can be removed from the diet. Fermentation caused by this digestive and absorption disorder in the intestines and accompanying problems such as gas, abdominal pain, and diarrhea can be prevented. However, An individualized diet plan should be made considering the possible adverse effects on intestinal microbiota and nutritional deficiencies that some restricted nutrients in the long-term application may cause. Further studies on long-term results and efficacy are needed.

Anahtar Kelimeler

FODMAP, Irritable Bowel Syndrome, Inflammatory Bowel Diseases, Non-celiac gluten sensitivity

FODMAP Diyeti ve Uygulandığı Hastalıklar

Öz

Fermente edilen oligosakkarit, disakkarit monosakkarit ve polioller; FODMAP’i ifade etmektedir. FODMAP grubu karbonhidratlar genellikle meyve ve sebze besin gruplarında zengin olarak bulunmaktadır. Bu grupta bulunan karbonhidratların emilimi zayıf, ancak yüksek ozmotik özellikleri vardır. Kolonda fermente edilmesiyle şişkinlik ve gaz oluşumuna sebebiyet verirler. Bu nedenle bazı hastalıklarda aşamalı olarak FODMAP grubu karbonhidratların diyetten çıkarılmasıyla beslenme tedavisi uygulanır. FODMAP diyetinin uygulandığı hastalıklar; irritabl bağırsak sendromu (İBS), inflamatuar bağırsak hastalıkları (İBH); çölyak tanısı olmayan gluten duyarlılığıdır (NCGS). İBS; karın ağrısı, şişkinlik ve defekasyon sonucu ağrının azalması ile karakterize bir gastrointestinal sistem hastalığıdır. İBH intestinal mukozadaki inflamasyon sonucu ortaya çıkan kronik ve tekrarlayıcı bir hastalıktır. Hastaların bazılarında ilk başta kabızlık görülse de, genellikle ishal ile seyreder. NCGS; IBS ile benzer belirgin belirtiler veren bununla birlikte çölyak hastalığı veya buğday alerjisinin tanı kriterlerine uymayan bir hastalıktır. Glutenin diyetten çıkarılması ile semptomlarda iyileşme görülmektedir. Bu hastalıkların beslenme tedavilerinin temelinde bazı besinlerin tüketildikten sonra rahatsızlık vermesi nedeniyle rahatsızlık veren besinin diyetten çıkarılması vardır. FODMAP diyetinde de benzer şekilde fermente oligosakkaritler, fruktan, rafinoz, inülin, laktoz, sukroz, früktoz ve şeker alkollerinden zengin besinler diyetten çıkarılarak semptomlarda iyileşme gözlemlenebilmektedir. Düşük FODMAP içeren besinlerin tercih edilmesi teşvik edilerek bağırsaklarda meydana gelen bu sindirim ve emilim bozukluğunun sebep olduğu fermentasyon ve beraberindeki gaz, karın ağrısı, diyare gibi problemler önlenebilmektedir. Ancak bu diyetin uzun dönemli uygulanmasında bağırsak mikrobiyotası üzerinde olası olumsuz etkileri ve kısıtlanan bazı besinlerin sebep olabileceği beslenme yetersizlikleri göz önünde bulundurularak bireylere özgü diyet planlaması yapılması tavsiye edilmektedir. Uzun dönemli sonuçları ve etkinliği üzerine ileri çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

FODMAP, İrritabl Bağırsak Sendromu, İnflamatuar Bağırsak Hastalıkları, Çölyak Tanısı Olmayan Gluten Duyarlılığı

Etik Beyan

Yazarlar herhangi bir çıkar çatışması beyan etmemiştir. Herhangi bir kurumdan mali destek alınmamıştır. Van Yüzüncü Yıl Üniversitesi 2. Uluslararası Sağlık Bilimleri Kongresi’nde sözlü bildiri olarak sunulmuştur. Derleme makale olduğu için etik kurul izni alınmamıştır.

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