The Low FODMAP Diet in Irritable Bowel Syndrome: Current State of Knowledge and Therapeutic Perspectives
DOI:
https://doi.org/10.12775/QS.2025.40.59768Keywords
irritable bowel syndrome, IBS, low FODMAP diet, gut microbiota, dietary therapy, Mediterranean diet, FODMAP reintroductionAbstract
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder that significantly reduces patients’ quality of life. One of the primary therapeutic approaches is the low FODMAP diet, which involves the restriction of fermentable oligo-, di-, monosaccharides, and polyols. The aim of this review is to summarize the current knowledge regarding the effectiveness of this diet in alleviating IBS symptoms, its impact on the gut microbiota, and its long-term health consequences. Research findings confirm that the low FODMAP diet effectively reduces symptoms, particularly in patients with diarrhea-predominant IBS (IBS-D), although long-term adherence may lead to a reduction in beneficial gut bacteria. Adherence challenges and the lack of clear guidelines on FODMAP reintroduction represent significant clinical issues. Alternative strategies, such as the Mediterranean diet, may help mitigate the negative effects of FODMAP elimination. The low FODMAP diet also shows potential in children and patients with inflammatory bowel disease (IBD), although further studies are needed. In the future, it will be essential to develop support strategies for patients and to personalize dietary recommendations, which may contribute to sustained improvements in the quality of life for individuals with IBS.
References
Algera, J. P., Demir, D., Törnblom, H., Nybacka, S., Simrén, M., & Störsrud, S. (2022). Low FODMAP diet reduces gastrointestinal symptoms in irritable bowel syndrome and clinical response could be predicted by symptom severity: A randomized crossover trial. Clinical Nutrition, 41(12), 2792–2800. https://doi.org/10.1016/j.clnu.2022.11.001
Bellini, M., Tonarelli, S., Barracca, F., Morganti, R., Pancetti, A., Bertani, L., de Bortoli, N., Costa, F., Mosca, M., Marchi, S., & Rossi, A. (2020). A low-FODMAP diet for irritable bowel syndrome: Some answers to the doubts from a long-term follow-up. Nutrients, 12(8), 2360. https://doi.org/10.3390/nu12082360
Bertin, L., Zanconato, M., Crepaldi, M., Marasco, G., Cremon, C., Barbara, G., Barberio, B., Zingone, F., & Savarino, E. V. (2024). The role of the FODMAP diet in IBS. Nutrients, 16(3), 370. https://doi.org/10.3390/nu16030370
Black, C. J., Staudacher, H. M., & Ford, A. C. (2022). Efficacy of a low FODMAP diet in irritable bowel syndrome: Systematic review and network meta-analysis. Gut, 71(6), 1117–1126. https://doi.org/10.1136/gutjnl-2021-325214
Dogan, G., Yavuz, S., Aslantas, H., Cengiz Ozyurt, B., & Kasirga, E. (2020). Is low FODMAP diet effective in children with irritable bowel syndrome? Northern Clinics of Istanbul, 7(5), 433–437. https://doi.org/10.14744/nci.2020.40326
Grammatikopoulou, M. G., Goulis, D. G., Gkiouras, K., Nigdelis, M. P., Papageorgiou, S. T., Papamitsou, T., Forbes, A., & Bogdanos, D. P. (2020). Low FODMAP diet for functional gastrointestinal symptoms in quiescent inflammatory bowel disease: A systematic review of randomized controlled trials. Nutrients, 12(12), 3648. https://doi.org/10.3390/nu12123648
Jayasinghe, M., Karunanayake, V., Mohtashim, A., Caldera, D., Mendis, P., Prathiraja, O., Rashidi, F., & Damianos, J. A. (2024). The role of diet in the management of irritable bowel syndrome: A comprehensive review. Cureus, 16(2), e54244. https://doi.org/10.7759/cureus.54244
Kasti, A. N., Katsas, K., Petsis, K., Lambrinou, S., Synodinou, K. D., Kapetani, A., Smart, K. L., Nikolaki, M. D., Halvatsiotis, P., Triantafyllou, K., & Muir, J. G. (2024). Is the Mediterranean low FODMAP diet effective in managing irritable bowel syndrome symptoms and gut microbiota? An innovative research protocol. Nutrients, 16(11), 1592. https://doi.org/10.3390/nu16111592
Khan, Z., Muhammad, S. A., Amin, M. S., & Gul, A. (2025). The efficacy of the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet in irritable bowel syndrome: A systematic review and meta-analysis. Cureus, 17(1), e77053. https://doi.org/10.7759/cureus.77053
Mentella, M. C., Scaldaferri, F., Pizzoferrato, M., Gasbarrini, A., & Miggiano, G. A. D. (2020). Nutrition, IBD and gut microbiota: A review. Nutrients, 12(4), 944. https://doi.org/10.3390/nu12040944
Morariu, I.-D., Avasilcai, L., Vieriu, M., Lupu, V. V., Morariu, B.-A., Lupu, A., Morariu, P.-C., Pop, O.-L., Starcea, I. M., & Trandafir, L. (2023). Effects of a low-FODMAP diet on irritable bowel syndrome in both children and adults—A narrative review. Nutrients, 15(10), 2295. https://doi.org/10.3390/nu15102295
Nikolaki, M. D., Kasti, A. N., Katsas, K., Petsis, K., Lambrinou, S., Patsalidou, V., Stamatopoulou, S., Karlatira, K., Kapolos, J., Papadimitriou, K., & Triantafyllou, K. (2023). The low-FODMAP diet, IBS, and BCFAs: Exploring the positive, negative, and less desirable aspects—A literature review. Microorganisms, 11(10), 2387. https://doi.org/10.3390/microorganisms11102387
Quigley, E. M. M. (2021). Low FODMAP (fermentable oligo-, di-, monosaccharides, and polyol) diet goes global. The American Journal of Clinical Nutrition, 113(6), 1394–1395. https://doi.org/10.1093/ajcn/nqab084
So, D., Loughman, A., & Staudacher, H. M. (2022). Effects of a low FODMAP diet on the colonic microbiome in irritable bowel syndrome: A systematic review with meta-analysis. The American Journal of Clinical Nutrition, 116(4), 943–952. https://doi.org/10.1093/ajcn/nqac176
Spiller, R. (2021). Impact of diet on symptoms of the irritable bowel syndrome. Nutrients, 13(2), 575. https://doi.org/10.3390/nu13020575
van Lanen, A.-S., de Bree, A., & Greyling, A. (2021). Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: A systematic review and meta-analysis. European Journal of Nutrition, 60, 3505–3522. https://doi.org/10.1007/s00394-020-02473-0
Wang, J., Yang, P., Zhang, L., & Hou, X. (2021). A low-FODMAP diet improves the global symptoms and bowel habits of adult IBS patients: A systematic review and meta-analysis. Frontiers in Nutrition, 8, 683191. https://doi.org/10.3389/fnut.2021.683191
Więcek, M., Panufnik, P., Kaniewska, M., Lewandowski, K., & Rydzewska, G. (2022). Low-FODMAP diet for the management of irritable bowel syndrome in remission of IBD. Nutrients, 14(21), 4562. https://doi.org/10.3390/nu14214562
Xie, C.-R., Tang, B., Shi, Y.-Z., Peng, W.-Y., Ye, K., Tao, Q.-F., Yu, S.-G., Zheng, H., & Chen, M. (2022). Low FODMAP diet and probiotics in irritable bowel syndrome: A systematic review with network meta-analysis. Frontiers in Pharmacology, 13, 853011. https://doi.org/10.3389/fphar.2022.853011
Zhang, H., & Su, Q. (2025). Low-FODMAP diet for irritable bowel syndrome: Insights from microbiome. Nutrients, 17(3), 544. https://doi.org/10.3390/nu17030544
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Copyright (c) 2025 Monika Barbara Solarz, Julia Piekarska, Justyna Maria Solarz, Jakub Tomasz Wawrzyńców, Weronika Cyrkler, Jakub Robak, Stanisław Telega, Paweł Bollin, Urszula Szymczak, Wojciech Wiesław Lachór
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