Many strategies for treating the symptoms of irritable bowel syndrome (IBS) involve dietary modifications; however, these diets can be restrictive. A recent study formulated low oral nutrition supplement (ONS) beverages with low fermentable oligo-, di- and monosaccharides and polyol (FODMAP) content and assessed their effects on the gastrointestinal (GI) tract.
IBS is a GI disorder affecting approximately 10% of the global population. There is no cure, but treatment can alleviate the symptoms, which include abdominal pain and changes in bowel movements. The causes of IBS are unknown but symptoms can be triggered by diet. IBS sufferers have problems absorbing carbohydrates. Undigested carbohydrates are fermented by bacteria in the colon, causing excess production of hydrogen, which contributes to the symptoms of IBS. The time until onset of IBS symptoms depends on how quickly the carbohydrates are fermented. Studies have appraised the success of a low-FODMAP diet. Although this diet can effectively reduce the symptoms of IBS, it is restrictive and may not provide the required nutrients. A recent study in the Nutrition Journal looked at ways to address this issue by formulating ONS beverages with a low FODMAP content.
Researchers conducted a double-blind, randomized-controlled, crossover study. They recruited 21 healthy adults aged 19-32 years without a history of gastrointestinal conditions. Subjects made four visits to a test facility, with seven days between each visit. Following a 12 hour fast, subjects consumed one of four different treatments during each visit. These included one of three ONS beverages containing less than 0.5 grams of FODMAPs and a control beverage containing 5 g fructooligosaccharides in lactose-free milk. A hydrogen breath test was performed at baseline, 1, 2, 3 and 4 hours following consumption as a measure of carbohydrate fermentation and bacterial overgrowth. GI tolerance was determined by GI symptom questionnaires filled in at baseline, 0.5, 1, 2, 3, 4, 12, 24 and 48 hours after consumption.
The three low FODMAP ONS beverages did not elevate hydrogen production, indicating that the may reduce the rapid onset of symptoms by reducing the rate of fermentation. However, an increase in hydrogen production was seen 3 and 4 hours after consumption of the control beverage. GI symptoms were similar for all four treatment groups, indicating that each treatment is well tolerated in healthy individuals.
Overall, the study suggests that low FODMAP ONS beverages have potential to benefit individuals with IBS. These beverages can easily be incorporated into the diet of IBS sufferers to enhance calorie intake or provide nutritional support. This study also demonstrated that these beverages have beneficial effects on the GI tract. However, a major limitation of this study was that only healthy individuals were assessed. The authors hypothesize that these beverages will be well tolerated and reduce symptoms in individuals with IBS. However, this can only be confirmed by repeating the study in a cohort of patients with IBS.
Written By: Natasha Tetlow, PhD