From Food Map to FODMAP in Irritable Bowel Sindrome.

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases in the general population, with a prevalence ranging from 12 % to 30 %, mainly affecting younger patients (i.e., <50 years of age) and women [1]. As in other chronic functional gastrointestinal disorders, abdominal discomfort or pain, abnormal bowel habits, and often bloating and abdominal distension are the main clinical features. Their diagnosis is based on symptom patterns (i.e., the Rome III criteria), which also allow categorization in diarrhea-predominant (D-IBS), constipation-predominant (C-IBS), mixed diarrhea and constipation (M-IBS), and unclassified (U-IBS) IBS [2]. Symptom severity ranges from tolerable to severe, both between different patients and in the same patient, affecting patients’ quality of life considerably as in some major chronic diseases [3]. Depending on whether diarrhea or constipation is the predominant disorder, antispasmodics, antidepressants, and medications modifying bowel habit represent the main conventional IBS treatments. Unfortunately, most patients report long-term inadequacy of current drug therapy and a tendency to seek a variety of alternative remedies, especially of a dietary nature (up to 65 % of them attribute their symptoms to adverse food reactions) [4]. However, the relationship between IBS symptoms and diet is still controversial, because of research quality and low number of scientific studies [5]. This represents a glaring gap that needs to be addressed.