{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:18:38Z","timestamp":1787761118789,"version":"build-2784847793"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>A randomized crossover study in eight patients (6 F, age 57 \u00b1 13) with overlapping GERD-IBS (non-constipation) was conducted to evaluate the effects of rice noodle vs. wheat noodle meals for breakfast and lunch on postprandial TLESR, intestinal gas production, and GERD\/GI symptoms. Results: Wheat ingestion was significantly associated with more frequent TLESR after lunch than rice (5.0 \u00b1 0.7 vs. 1.9 \u00b1 0.3 times\/2 h, p = 0.01). After lunch, wheat ingestion was significantly associated with higher H2 and CH4 levels compared to rice ingestion (p &lt; 0.05), while H2 and CH4 levels before lunch were similar (p &gt; 0.05). The area under curve of H2 concentration until 2 h after lunch significantly correlated with the TLESR number (r = 0.69, p = 0.04). Postprandial regurgitation (2.9 \u00b1 1.2 vs. 0.4 \u00b1 0.2), bloating (7.0 \u00b1 0.4 vs. 3.1 \u00b1 0.9), satiety (7.7 \u00b1 0.4 vs. 3.5 \u00b1 0.9), and belching (3.8 \u00b1 1.2 vs. 1.1 \u00b1 0.6) symptom scores were significantly greater after wheat compared to rice noodle ingestion (p &lt; 0.05). Conclusion: Wheat noodle meals, part of a high FODMAP diet, induced a higher frequency of TLESRs, a higher GERD, and higher upper-GI symptom scores than rice noodle meals, part of a low FODMAP diet, in patients with overlapping IBS-GERD. These effects were associated with more intestinal gas production. Thus, a low FODMAP diet may relieve GERD symptoms in GERD patients with overlapping IBS.<\/jats:p>","DOI":"10.3390\/nu14091755","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T21:39:45Z","timestamp":1650749985000},"page":"1755","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The Effect of Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) Meals on Transient Lower Esophageal Relaxations (TLESR) in Gastroesophageal Reflux Disease (GERD) Patients with Overlapping Irritable Bowel Syndrome (IBS)"],"prefix":"10.3390","volume":"14","author":[{"given":"Suppawatsa","family":"Plaidum","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1324-2394","authenticated-orcid":false,"given":"Tanisa","family":"Patcharatrakul","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand"},{"name":"Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wachinee","family":"Promjampa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sutep","family":"Gonlachanvit","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand"},{"name":"Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1038\/ajg.2012.336","article-title":"Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: A meta-analysis","volume":"107","author":"Lovell","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1007\/s10620-006-9306-y","article-title":"Studying the overlap between IBS and GERD: A systematic review of the literature","volume":"51","author":"Nastaskin","year":"2006","journal-title":"Dig. Dis. Sci."},{"key":"ref_3","first-page":"3235","article-title":"Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease","volume":"17","author":"Heading","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_4","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_5","doi-asserted-by":"crossref","unstructured":"Patcharatrakul, T., Juntrapirat, A., Lakananurak, N., and Gonlachanvit, S. (2019). Effect of Structural Individual Low-FODMAP Dietary Advice vs. Brief Advice on a Commonly Recommended Diet on IBS Symptoms and Intestinal Gas Production. Nutrients, 11.","DOI":"10.3390\/nu11122856"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"906","DOI":"10.14309\/ajg.0000000000000641","article-title":"\u03b2-Galactooligosaccharide in Conjunction with Low FODMAP Diet Improves Irritable Bowel Syndrome Symptoms but Reduces Fecal Bifidobacteria","volume":"115","author":"Wilson","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_7","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_8","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_9","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1111\/jgh.15410","article-title":"Low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol diet in patients with diarrhea-predominant irritable bowel syndrome: A prospective, randomized trial","volume":"36","author":"Goyal","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_10","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_11","doi-asserted-by":"crossref","first-page":"4632","DOI":"10.3748\/wjg.v23.i25.4632","article-title":"Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs","volume":"23","author":"Harvie","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3356","DOI":"10.3748\/wjg.v23.i18.3356","article-title":"Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease","volume":"23","author":"Pedersen","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_13","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_14","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_15","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1111\/jgh.14051","article-title":"Low fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial","volume":"33","author":"Zahedi","year":"2018","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1093\/ajcn\/nqab005","article-title":"Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: A parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomes","volume":"113","author":"Zhang","year":"2021","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1038\/ajg.2012.444","article-title":"Guidelines for the diagnosis and management of gastroesophageal reflux disease","volume":"108","author":"Katz","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_18","first-page":"175","article-title":"Lifestyle Intervention in Gastroesophageal Reflux Disease","volume":"14","author":"Hveem","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_19","first-page":"439","article-title":"The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms","volume":"5","author":"Fox","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol. Off. Clin. Pract. J. Am. Gastroenterol. Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/MOG.0000000000000337","article-title":"Diet and gastroesophageal reflux disease: Role in pathogenesis and management","volume":"33","author":"Sethi","year":"2017","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1053\/gast.1996.v111.pm8690193","article-title":"Colonic fermentation and proximal gastric tone in humans","volume":"111","author":"Ropert","year":"1996","journal-title":"Gastroenterology"},{"key":"ref_22","first-page":"1078","article-title":"Simultaneous study of tones of the lower esophageal sphincter and proximal stomach in healthy humans","volume":"20","author":"Zerbib","year":"1996","journal-title":"Gastroent\u00e9rologie Clin. Biol."},{"key":"ref_23","first-page":"G578","article-title":"Modulation by colonic fermentation of LES function in humans","volume":"278","author":"Piche","year":"2000","journal-title":"Am. J. Physiol. Liver Physiol."},{"key":"ref_24","first-page":"G1266","article-title":"Endogenous cholecystokinin in postprandial lower esophageal sphincter function and fundic tone in humans","volume":"275","author":"Zerbib","year":"1998","journal-title":"Am. J. Physiol. Content"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Linlawan, S., Patcharatrakul, T., and Gonlachanvit, S. (2019). Effect of Rice, Wheat and Mung Bean Ingestion on Intestinal Gas Production and Postprandial Gastrointestinal Symptoms in Non-constipation Irritable Bowel Syndrome Patients. Nutrients, 11.","DOI":"10.3390\/nu11092061"},{"key":"ref_26","unstructured":"USDA (2020, March 10). Food Data Central, Available online: https:\/\/ndb.nal.usda.gov\/ndb\/search\/list."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1136\/gut.2005.075127","article-title":"Use and abuse of hydrogen breath tests","volume":"55","author":"Simren","year":"2006","journal-title":"Gut"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1111\/j.1365-2036.2011.04728.x","article-title":"High resolution manometry to detect transient lower oesophageal sphincter relaxations: Diagnostic accuracy compared with perfused-sleeve manometry, and the definition of new detection criteria","volume":"34","author":"Roman","year":"2011","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1053\/gast.2003.50159","article-title":"Colonic fermentation influences lower esophageal sphincter function in gastroesophageal reflux disease","volume":"124","author":"Piche","year":"2003","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.jada.2006.07.010","article-title":"Fructose malabsorption and symptoms of irritable bowelsyndrome: Guidelines for effective dietary management","volume":"106","author":"Shepherd","year":"2006","journal-title":"Am. Diet. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Patcharatrakul, T., Linlawan, S., Plaidum, S., and Gonlachanvit, S. (2021). The Effect of Rice vs. Wheat Ingestion on Postprandial Gastroesophageal Reflux (GER) Symptoms in Patients with Overlapping GERD-Irritable Bowel Syndrome (IBS). Foods, 11.","DOI":"10.3390\/foods11010026"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5056\/jnm.2010.16.2.131","article-title":"Are rice and spicy diet good for functional gastrointestinal disorders?","volume":"16","author":"Gonlachanvit","year":"2010","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1053\/j.gastro.2006.07.015","article-title":"Relationship of abdominal bloating to distention in irritable bowel syndrome and effect of bowel habit","volume":"131","author":"Houghton","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e14181","DOI":"10.1111\/nmo.14181","article-title":"Low FODMAPs diet or usual dietary advice for the treatment of refractory gastroesophageal reflux disease: An open-labeled randomized trial","volume":"33","author":"Vauquelin","year":"2021","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e13727","DOI":"10.1111\/nmo.13727","article-title":"Acute administration of fructans increases the number of transient lower esophageal sphincter relaxations in healthy volunteers","volume":"32","author":"Geysen","year":"2019","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1038\/ejcn.2013.78","article-title":"Delayed gastric emptying and reduced postprandial small bowel water content of equicaloric whole meal bread versus rice meals in healthy subjects: Novel MRI insights","volume":"67","author":"Marciani","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Patcharatrakul, T., Kriengkirakul, C., Chaiwattanarat, T., and Gonlachanvit, S. (2020). Acute Effects of Red Chili, a Natural Capsaicin Receptor Agonist, on Gastric Accommodation and Upper Gastrointestinal Symptoms in Healthy Volunteers and Gastroesophageal Reflux Disease Patients. Nutrients, 12.","DOI":"10.3390\/nu12123740"},{"key":"ref_38","first-page":"751","article-title":"The effect of gluten on intestinal fermentation, gastric and gallbladder emptying in healthy volunteers","volume":"47","author":"Bergonzi","year":"2015","journal-title":"Dig. Liver Dis. Off. J. Ital. Soc. Gastroenterol. Ital. Assoc. Study Liver"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1056\/NEJM198104093041507","article-title":"Incomplete absorption of the carbohydrate in all-purpose wheat flour","volume":"304","author":"Anderson","year":"1981","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1111\/j.1440-1746.2008.05507.x","article-title":"Effect of gluten-free diet on preventing recurrence of gastroesophageal reflux disease-related symptoms in adult celiac patients with nonerosive reflux disease","volume":"23","author":"Usai","year":"2008","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1111\/nmo.12456","article-title":"Hydrogen breath test in patients with severe constipation: The interference of the mixing of intestinal content","volume":"26","author":"Mengoli","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1097\/MEG.0000000000000979","article-title":"The overlap of gastroesophageal reflux disease and functional constipation in children: The efficacy of constipation treatment","volume":"29","author":"Baran","year":"2017","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2515690X18763294","article-title":"Comparing the Effect of Psyllium Seed on Gastroesophageal Reflux Disease with Oral Omeprazole in Patients With Functional Constipation","volume":"23","author":"Hosseini","year":"2018","journal-title":"J. Evid.-Based Integr. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/9\/1755\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:59:03Z","timestamp":1760137143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/9\/1755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,22]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["nu14091755"],"URL":"https:\/\/doi.org\/10.3390\/nu14091755","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,22]]}}}