Introduction
Functional Dyspepsia (FD) is a common disorder where subjects experience bloating, belching, epigastric pain and discomfort. A subset of patients with FD experience triggers exclusively related to meals, known as post-prandial distress syndrome in the Rome III guidelines. There is significant overlap of symptoms with another common functional gastrointestinal disorder, irritable bowel syndrome (IBS) and in fact, a significant proportion of subjects have FD/IBS overlap. This review aims to examine the current role of diet in the management of FD and FD/IBS overlap in East Asia, with an exploration of the likely efficacy and mechanisms of action of the low FODMAP diet in these subjects. .
Method
Pubmed, Embase and Google Scholar were screened for original studies and reviews examining the role of diet in the management of subjects with FD or FD/IBS overlap in East Asia. Publications were included if they were published in English, related to the East Asia region and included subjects who fulfilled the Rome I, II or III criteria for FD or FD/IBS overlap. Mapping of the known mechanisms of action of the low FODMAP diet to current pathophysiological mechanisms suspected to contribute to symptoms in FD and IBS was undertaken.
Results FD and FD/IBS overlap is common in the East Asia region. In particular, it is evident that a proportion of subjects with IBS may have been misdiagnosed with FD due to the predominance of upper gastrointestinal symptoms in IBS in this region. Dietary manipulation is widely employed in the management of FD and FD/IBS overlap in East Asia but this occurs without the input of dieticians or in a structured fashion. In terms of the ow FODMAP diet a reduction in delivery of highly fermentable substrates to the distal small intestine and large colon is likely to reduce the sensation of bloating and epigastric discomfort/pain in subjects with FD and FD/IBS overlap..
Conclusions Dietary manipulation is widely employed by patients and clinicians in East Asia to manage FD and FD/IBS overlap. The low FODMAP diet appears to address some of
the mechanism implicated in the genesis of symptoms in FD and FD/IBS and holds great promise as a treatment modality.
Declarations: The author has no funding sources to declare.