The sick gut with diarrhea: FODMAPS for treatment?

Purpose of review: To examine in the light of recent data whether diets low in FODMAPs (a now classic exclusion diet for treatment for IBS: irritable bowel syndrome) have shown interest/efficacy in diseases of the digestive tract (beyond IBS) manifesting as diarrhea.

Recent findings: Very little good quality data or publications are available in recent medical literature. It is therefore difficult to estimate that the low FODMAP diet can be considered with a good level of confidence outside of IBS except in borderline symptomatic forms or with associated pathophysiology (e.g. IBD: inflammatory bowel disease).

Summary: There is a lack of quality data on the benefits, safety and value of LFD, outside of IBS. This is particularly the case in the majority of organic digestive diseases, notably with diarrhea, unless accompanied by dysregulation of the intestine-brain axis (and so with IBS symptoms), for example in post-inflammatory situations. When effective, which is currently highly unpredictable, the mechanism of action remains poorly understood.