{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:29:45Z","timestamp":1784752185349,"version":"3.55.0"},"reference-count":102,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["13409, 21691 and 21692"],"award-info":[{"award-number":["13409, 21691 and 21692"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2018-00182"],"award-info":[{"award-number":["2018-00182"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005760","name":"G\u00f6teborgs Universitet","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007773","name":"Danone","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100007773","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Even though irritable bowel syndrome (IBS) has been known for more than 150 years, it still remains one of the research challenges of the 21st century. According to the current diagnostic Rome IV criteria, IBS is characterized by abdominal pain associated with defecation and\/or a change in bowel habit, in the absence of detectable organic causes. Symptoms interfere with the daily life of patients, reduce health-related quality of life and lower the work productivity. Despite the high prevalence of approximately 10%, its pathophysiology is only partly understood and seems multifactorial. However, many patients report symptoms to be meal-related and certain ingested foods may generate an exaggerated gastrointestinal response. Patients tend to avoid and even exclude certain food products to relieve their symptoms, which could affect nutritional quality. We performed a narrative paper review of the existing and emerging evidence regarding dietary management of IBS patients, with the aim to enhance our understanding of how to move towards an individualized dietary approach for IBS patients in the near future.<\/jats:p>","DOI":"10.3390\/nu11092162","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T11:26:17Z","timestamp":1568028377000},"page":"2162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":98,"title":["The Dietary Management of Patients with Irritable Bowel Syndrome: A Narrative Review of the Existing and Emerging Evidence"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3877-3191","authenticated-orcid":false,"given":"Joost","family":"Algera","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"},{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC (location VUmc), VU University Amsterdam, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Colomier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"},{"name":"Department of Translational Research for Gastrointestinal Disorders, University Hospital KU Leuven, University of Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Simr\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.cgh.2012.02.029","article-title":"Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis","volume":"10","author":"Lovell","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1136\/gutjnl-2015-311240","article-title":"The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: A Rome Foundation working team literature review","volume":"66","author":"Sperber","year":"2017","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel disorders","volume":"150","author":"Lacy","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1053\/j.gastro.2005.11.061","article-title":"Functional Bowel Disorders","volume":"130","author":"Longstreth","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16014","DOI":"10.1038\/nrdp.2016.14","article-title":"Irritable bowel syndrome","volume":"2","author":"Enck","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1053\/j.gastro.2010.12.014","article-title":"Advances in imaging the BrainGut axis: Functional gastrointestinal disorders","volume":"140","author":"Tillisch","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S52","DOI":"10.1097\/MCG.0b013e318264e918","article-title":"Mucosal permeability and immune activation as potential therapeutic targets of probiotics in irritable bowel syndrome","volume":"46","author":"Barbara","year":"2012","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1053\/j.gastro.2016.09.049","article-title":"Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome","volume":"152","author":"Tap","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1177\/2050640613501817","article-title":"Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls","volume":"1","author":"Posserud","year":"2013","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.dld.2006.10.014","article-title":"New insights into the pathogenesis and pathophysiology of irritable bowel syndrome","volume":"39","year":"2007","journal-title":"Dig. Liver Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1038\/nrgastro.2010.4","article-title":"Pathogenesis of IBS: Role of inflammation, immunity and neuroimmune interactions","volume":"7","year":"2010","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S2468-1253(16)30116-9","article-title":"Management of the multiple symptoms of irritable bowel syndrome","volume":"2","author":"Palsson","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/ajg.2013.105","article-title":"Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life","volume":"108","author":"Bengtsson","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1159\/000051878","article-title":"Food-related gastrointestinal symptoms in the irritable bowel syndrome","volume":"63","author":"Langkilde","year":"2001","journal-title":"Digestion"},{"key":"ref_15","first-page":"e1","article-title":"Lactulose Challenge Determines Visceral Sensitivity and Severity of Symptoms in Patients With Irritable Bowel Syndrome","volume":"14","author":"Brazeilles","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"437","DOI":"10.5056\/jnm17116","article-title":"Use of Dietary Management in Irritable Bowel Syndrome: Results of a Survey of over 1500 U.S. Gastroenterologists","volume":"24","author":"Lenhart","year":"2018","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1038\/sj.ejcn.1602367","article-title":"Perceived food intolerance in subjects with irritable bowel syndrome-Etiology, prevalence and consequences","volume":"60","author":"Monsbakken","year":"2006","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/S0140-6736(82)92782-9","article-title":"Food intolerance: A major factor in the pathogenesis of irritable bowel syndrome","volume":"2","author":"Jones","year":"1982","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0140-6736(83)90285-4","article-title":"Food hypersensitivity in irritable bowel syndrome","volume":"2","author":"Bentley","year":"1983","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S0140-6736(87)93076-5","article-title":"The bran wagon","volume":"2","author":"Suri","year":"1987","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(77)90605-5","article-title":"Wheat fibre and irritable bowel syndrome. A Controlled Trial","volume":"2","author":"Manning","year":"1977","journal-title":"Lancet"},{"key":"ref_22","first-page":"601","article-title":"The value of prescribed high-fiber diets for the treatment of the irritable-bowel-syndrome","volume":"45","author":"Lambert","year":"1991","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"295","DOI":"10.3109\/00365528509091653","article-title":"The effect of coarse wheat bran in the irritable bowel syndrome. A double-blind Cross-over study","volume":"20","author":"Arffmann","year":"1985","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_24","first-page":"470","article-title":"Bran: May irritate irritable bowel","volume":"14","author":"Lewis","year":"1998","journal-title":"Nutrition"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1136\/gut.30.8.1099","article-title":"Food intolerances and irritable bowel syndrome","volume":"30","author":"Nanda","year":"1989","journal-title":"Gut"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/00004836-198710000-00007","article-title":"Exclusion diets in irritable bowel syndrome: Are they worthwhile?","volume":"9","author":"McKee","year":"1987","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_27","first-page":"47","article-title":"The irritable bowel syndrome and food hypersensitivity","volume":"61","author":"Zwetchkenbaum","year":"1988","journal-title":"Ann. Allergy"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0889-8553(21)00553-7","article-title":"Diet and the irritable bowel syndrome","volume":"20","author":"Friedman","year":"1991","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1046\/j.1365-277X.2001.00284.x","article-title":"Dietary treatment of irritable bowel syndrome: Current evidence and guidelines for future practice","volume":"14","author":"Burden","year":"2001","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1136\/gut.2003.037697","article-title":"Food elimination based on IgG antibodies in irritable bowel syndrome: A randomised controlled trial","volume":"53","author":"Atkinson","year":"2004","journal-title":"Gut"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1080\/00365520510015593","article-title":"Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome","volume":"40","author":"Zar","year":"2005","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1080\/07315724.2006.10719567","article-title":"Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics","volume":"25","author":"Drisko","year":"2006","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_33","first-page":"1","article-title":"Gastrointestinal Transit Time, Glucose Homeostasis and Metabolic Health: Modulation by Dietary Fibers","volume":"10","author":"Canfora","year":"2018","journal-title":"Nutrients"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0140-6736(94)91055-3","article-title":"Bran and irritable bowel syndrome: Time for reappraisal","volume":"344","author":"Francis","year":"1994","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/j.0269-2813.2004.01862.x","article-title":"Systematic review: The role of different types of fibre in the treatment of irritable bowel syndrome","volume":"19","author":"Bijkerk","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1136\/bmj.b3154","article-title":"Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial","volume":"339","author":"Bijkerk","year":"2009","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1038\/ajg.2014.195","article-title":"The effect of fiber supplementation on irritable bowel syndrome: A systematic review and meta-analysis","volume":"109","author":"Moayyedi","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/jaoac\/93.1.221","article-title":"Determination of Insoluble, Soluble, and Total Dietary Fiber (CODEX Definition) by Enzymatic-Gravimetric Method and Liquid Chromatography: Collaborative Study","volume":"93","author":"McCleary","year":"2010","journal-title":"J. AOAC Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"De Vries, J., Birkett, A., Hulshof, T., Verbeke, K., and Gibes, K. (2016). Effects of Cereal, Fruit and Vegetable Fibers on Human Fecal Weight and Transit Time: A Comprehensive Review of Intervention Trials. Nutrients, 8.","DOI":"10.3390\/nu8030130"},{"key":"ref_40","first-page":"710","article-title":"Irritable bowel syndrome in adults in primary care: Summary of updated NICE guidance","volume":"350","author":"Hookway","year":"2015","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/003655299750025525","article-title":"Coffee and Gastrointestinal Function: Facts and Fiction. A Review","volume":"34","author":"Boekema","year":"1999","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1002\/ar.21192","article-title":"Chronic alcohol consumption affects gastrointestinal motility and reduces the proportion of neuronal NOS-immunoreactive myenteric neurons in the murine jejunum","volume":"293","author":"Krecsmarik","year":"2010","journal-title":"Anat. Rec."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/00042737-200603000-00006","article-title":"Capsaicin receptor (TRPV1) and non-erosive reflux disease","volume":"18","author":"Bhat","year":"2006","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1136\/gut.48.1.20","article-title":"An exaggerated sensory component of the gastrocolonic response in patients with irritable bowel syndrome","volume":"48","author":"Abrahamsson","year":"2001","journal-title":"Gut"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/jhn.12530","article-title":"The low FODMAP diet in the management of irritable bowel syndrome: An evidence-based review of FODMAP restriction, reintroduction and personalisation in clinical practice","volume":"31","author":"Whelan","year":"2018","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1111\/j.1440-1746.2010.06370.x","article-title":"Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome","volume":"25","author":"Ong","year":"2010","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/j.1365-2036.2010.04237.x","article-title":"Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon","volume":"31","author":"Barrett","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/ajg.2013.96","article-title":"Short-chain carbohydrates and functional gastrointestinal disorders","volume":"108","author":"Shepherd","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1038\/ajg.2013.386","article-title":"Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI","volume":"109","author":"Murray","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.gastro.2013.09.046","article-title":"A diet low in FODMAPs reduces symptoms of irritable bowel syndrome","volume":"146","author":"Halmos","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1053\/j.gastro.2015.07.054","article-title":"Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome as Well as Traditional Dietary Advice: A Randomized Controlled Trial","volume":"149","author":"Liljebo","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"O\u2019Keeffe, M. (2018). Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome. Neurogastroenterol. Motil., 30.","DOI":"10.1111\/nmo.13154"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1038\/ajg.2016.434","article-title":"A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D","volume":"111","author":"Eswaran","year":"2016","journal-title":"Am. J. Gastroenterol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/j.cgh.2017.06.044","article-title":"A Diet Low in Fermentable Oligo-, Di-, and Monosaccharides and Polyols Improves Quality of Life and Reduces Activity Impairment in Patients With Irritable Bowel Syndrome and Diarrhea","volume":"15","author":"Eswaran","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1038\/s41395-018-0195-4","article-title":"Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPs Diet in Treating Symptoms of Irritable Bowel Syndrome","volume":"113","author":"Dionne","year":"2018","journal-title":"Am. J. Gastroenterol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1136\/gutjnl-2014-307264","article-title":"Diets that differ in their FODMAP content alter the colonic luminal microenvironment","volume":"64","author":"Halmos","year":"2015","journal-title":"Gut"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1053\/j.gastro.2017.06.010","article-title":"A Diet Low in FODMAPs Reduces Symptoms in Patients With Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial","volume":"153","author":"Staudacher","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.jada.2006.07.010","article-title":"Fructose Malabsorption and Symptoms of Irritable Bowel Syndrome: Guidelines for Effective Dietary Management","volume":"106","author":"Shepherd","year":"2006","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/j.1365-277X.2011.01162.x","article-title":"Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome","volume":"24","author":"Staudacher","year":"2011","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.3945\/jn.112.159285","article-title":"Fermentable Carbohydrate Restriction Reduces Luminal Bifidobacteria and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome","volume":"142","author":"Staudacher","year":"2012","journal-title":"J. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/ijcp.12128","article-title":"The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: A prospective study","volume":"67","author":"Dobbs","year":"2013","journal-title":"Int. J. Clin. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e12969","DOI":"10.1111\/nmo.12969","article-title":"Effects of varying dietary content of fermentable short-chain carbohydrates on symptoms, fecal microenvironment, and cytokine profiles in patients with irritable bowel syndrome","volume":"29","author":"Hustoft","year":"2017","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1136\/gutjnl-2015-311339","article-title":"FODMAPs alter symptoms and the metabolome of patients with IBS: A randomised controlled trial","volume":"66","author":"McIntosh","year":"2017","journal-title":"Gut"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/nu10111599","article-title":"Lactose Maldigestion, Malabsorption, and Intolerance: A Comprehensive Review with a Focus on Current Management and Future Perspectives","volume":"10","author":"Fassio","year":"2018","journal-title":"Nutrients"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/nu10121994","article-title":"Lactose Intolerance, Dairy Avoidance, and Treatment Options","volume":"10","author":"Szilagyi","year":"2018","journal-title":"Nutrients"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1093\/ajcn\/67.4.710","article-title":"Role of irritable bowel syndrome in subjective lactose intolerance","volume":"67","author":"Vesa","year":"1998","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1097\/00042737-199610000-00015","article-title":"The clinical relevance of lactose malabsorption in irritable bowel syndrome","volume":"8","author":"Tuynman","year":"1996","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1097\/00042737-200108000-00011","article-title":"The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: A 5-year follow-up study","volume":"13","author":"Tuynman","year":"2001","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1007\/BF01299809","article-title":"Lactose Malabsorption and Intolerance in Italians Clinical Implications","volume":"31","author":"Bozzani","year":"1986","journal-title":"Dig. Dis. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00042737-200103000-00001","article-title":"Irritable bowel syndrome: Is the search for lactose intolerance justified?","volume":"13","author":"Parker","year":"2001","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/jhn.12385","article-title":"British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)","volume":"29","author":"McKenzie","year":"2016","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1228S","DOI":"10.3945\/jn.108.098277","article-title":"National Estimates of Dietary Fructose Intake Increased from 1977 to 2004 in the United States","volume":"139","author":"Marriott","year":"2009","journal-title":"J. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/MCG.0b013e31802cbc2f","article-title":"Fructose intolerance in IBS and utility of fructose-restricted diet","volume":"42","author":"Choi","year":"2008","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1007\/s00394-018-1636-y","article-title":"Overweight and diabetes prevention: Is a low-carbohydrate-high-fat diet recommendable?","volume":"57","author":"Brouns","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1136\/bjsports-2016-096491","article-title":"Evidence that supports the prescription of low-carbohydrate high-fat diets: A narrative review","volume":"51","author":"Noakes","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s12020-018-1580-x","article-title":"More sugar? No, thank you! The elusive nature of low carbohydrate diets","volume":"61","author":"Giugliano","year":"2018","journal-title":"Endocrine"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1515\/hukin-2017-0025","article-title":"Low-Carbohydrate-High-Fat Diet: Can it Help Exercise Performance?","volume":"56","author":"Chang","year":"2017","journal-title":"J. Hum. Kinet."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.cgh.2009.02.023","article-title":"A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome","volume":"7","author":"Austin","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/jgh.13703","article-title":"What is gluten?","volume":"32","author":"Biesiekierski","year":"2017","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/j.1365-277X.2010.01139.x","article-title":"Quantification of fructans, galacto-oligosacharides and other short-chain carbohydrates in processed grains and cereals","volume":"24","author":"Biesiekierski","year":"2011","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"275","DOI":"10.12998\/wjcc.v3.i3.275","article-title":"Clinical and diagnostic aspects of gluten related disorders","volume":"3","author":"Tovoli","year":"2015","journal-title":"World J. Clin. Cases"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"10417","DOI":"10.3390\/nu7125541","article-title":"The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma","volume":"7","author":"Makharia","year":"2015","journal-title":"Nutrients"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/gutjnl-2011-301346","article-title":"The Oslo definitions for coeliac disease and related terms","volume":"62","author":"Ludvigsson","year":"2013","journal-title":"Gut"},{"key":"ref_84","first-page":"1","article-title":"Non-coeliac gluten sensitivity and the spectrum of gluten-related disorders: An updated overview","volume":"16","author":"Dale","year":"2018","journal-title":"Nutr. Res. Rev."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"4966","DOI":"10.3390\/nu7064966","article-title":"Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts Criteria","volume":"7","author":"Castillejo","year":"2015","journal-title":"Nutrients"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.gastro.2013.04.051","article-title":"No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates","volume":"145","author":"Biesiekierski","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.cgh.2016.08.007","article-title":"Suspected Nonceliac Gluten Sensitivity Confirmed in Few Patients After Gluten Challenge in Double-Blind, Placebo-Controlled Trials","volume":"15","author":"Carroccio","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1053\/j.gastro.2017.10.040","article-title":"Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity","volume":"154","author":"Skodje","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/nmo.13332","article-title":"The effect of a controlled gluten challenge in a group of patients with suspected non-coeliac gluten sensitivity: A randomized, double-blind placebo-controlled challenge","volume":"30","author":"Dale","year":"2018","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1097\/MCG.0000000000000515","article-title":"Intestinal, Systemic, and Oral Gluten-related Alterations in Patient with Nonceliac Gluten Sensitivity","volume":"50","author":"Picarelli","year":"2016","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.cgh.2015.12.031","article-title":"Efficacy of a Gluten-Free Diet in Subjects With Irritable Bowel Syndrome-Diarrhea Unaware of Their HLA-DQ2\/8 Genotype","volume":"14","author":"Aziz","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/nu8020084","article-title":"Evidence for the Presence of Non-Celiac Gluten Sensitivity in Patients with Functional Gastrointestinal Symptoms: Results from a Multicenter Randomized Placebo-Controlled Gluten Challenge","volume":"8","author":"Elli","year":"2016","journal-title":"Nutrients"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"4542","DOI":"10.3390\/nu7064542","article-title":"Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: A double-blind randomized placebo-controlled trial","volume":"7","author":"Shahbazkhani","year":"2015","journal-title":"Nutrients"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1016\/j.cgh.2015.01.029","article-title":"Small Amounts of Gluten in Subjects With Suspected Nonceliac Gluten Sensitivity: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial","volume":"13","author":"Volta","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1111\/apt.12730","article-title":"Randomised clinical trial: Gluten may cause depression in subjects with non-coeliac gluten sensitivity\u2013An exploratory clinical study","volume":"39","author":"Peters","year":"2014","journal-title":"Aliment Pharmacol. Ther."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1053\/j.gastro.2013.01.049","article-title":"A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: Effects on bowel frequency and intestinal function","volume":"144","author":"Camilleri","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1038\/ajg.2012.236","article-title":"Non-Celiac Wheat Sensitivity Diagnosed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity","volume":"107","author":"Carroccio","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1038\/ajg.2010.487","article-title":"Gluten Causes gastrointestinal symptoms in subjects without celiac disease: A double-blind randomized placebo-controlled trial","volume":"106","author":"Biesiekierski","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1038\/ajg.2013.77","article-title":"Design of clinical trials evaluating dietary interventions in patients with functional gastrointestinal disorders","volume":"108","author":"Yao","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1365-2036.2010.04328.x","article-title":"Meta-analysis: Factors affecting placebo response rate in the irritable bowel syndrome","volume":"32","author":"Ford","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1053\/j.gastro.2016.02.010","article-title":"Design of Treatment Trials for Functional Gastrointestinal Disorders","volume":"150","author":"Irvine","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1136\/gutjnl-2016-313128","article-title":"Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs","volume":"67","author":"Bennet","year":"2018","journal-title":"Gut"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2162\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:18:10Z","timestamp":1760188690000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,9]]},"references-count":102,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["nu11092162"],"URL":"https:\/\/doi.org\/10.3390\/nu11092162","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,9]]}}}