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. Author manuscript; available in PMC: 2016 Dec 1.
Published in final edited form as: Aliment Pharmacol Ther. 2015 Dec;42(11-12):1330. doi: 10.1111/apt.13420

Letter: avoid FODMAPs or follow simple tips – authors’ reply

B P Chumpitazi *, R J Shulman †
PMCID: PMC4830344  NIHMSID: NIHMS774563  PMID: 26510543

Sirs, We thank Drs Mennini and Ferrari for their letter1 regarding our double-blind randomised, crossover study evaluating the low FODMAP dietary intervention in children with irritable bowel syndrome (IBS).2 We agree that our study supports growing evidence that a low FODMAP diet ameliorates gastrointestinal symptoms in both children and adults with IBS.3, 4

We also agree that it is worth investigating other potential dietary interventions given that our study and others have found that not all patients with IBS respond to a low FODMAP diet. As we have suggested, identifying baseline (prior to starting a dietary intervention) biomarkers, which may include faecal microbiota composition and metabolic potential, may help lead to personalised interventions for those with IBS and identify who may benefit most.2

With respect to the study by Bohn et al.,5 we agree that the findings are quite interesting. We note that the study is single-blind and did not enroll children. In addition, there was an overlap between the two studied diets with respect to restriction of FODMAP carbohydrates. The traditional IBS dietary group was allowed to maintain lactose restriction, reduced intake of foods with fructans (onions) and galactans (beans), and avoided polyols. In addition, there was a significant decrease in excess fructose intake in the traditional IBS dietary group.5

Nonetheless we look forward to seeing more work with the described traditional IBS diet, the low FODMAP diet, and other dietary regimens in children and adults with IBS to identify which are the most effective. Further research identifying baseline factors that determine the best personalised dietary regimen for those with IBS is needed.

ACKNOWLEDGEMENT

The authors’ declarations of personal and financial interests are unchanged from those in the original article.2

REFERENCES

  • 1.Mennini M, Ferrari F. Letter: avoid FODMAPs or follow simple tips? Aliment Pharmacol Ther. 2015;42:1329. doi: 10.1111/apt.13391. [DOI] [PubMed] [Google Scholar]
  • 2.Chumpitazi BP, Cope JL, Hollister EB, et al. Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Aliment Pharmacol Ther. 2015;42:418–27. doi: 10.1111/apt.13286. [DOI] [PMC free article] [PubMed] [Google Scholar]
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