Low-FODMAP Diet for Irritable Bowel Syndrome
A limited trial of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is recommended to improve global IBS symptoms (ACG guideline recommendation: recommended; strength of recommendation not specified in the accessible abstract) [1]. Low-FODMAP fruit portion sizes depend on elimination-phase serving limits [2].
Safety of Specific Fruits Within Low-FODMAP Portions
Black and green grapes can be eaten for IBS when the serving size is limited to the elimination-phase low-FODMAP portion [2]. Papaya can be eaten for IBS when the serving size is limited to the elimination-phase low-FODMAP portion [2]. Pineapple can be eaten for IBS when the serving size is limited to the elimination-phase low-FODMAP portion [2].
Portion Sizes Recommended (Elimination-Phase Low-FODMAP Servings)
The following elimination-phase low-FODMAP serving sizes are listed for each fruit [2].
- Grapes: 1/2 cup [2].
- Papaya: 1 cup [2].
- Pineapple: 1/2 cup [2].
Monotherapy vs Combination Nutrition Strategy
Fruit intake should follow low-FODMAP elimination-phase serving limits during the trial period [2]. Other IBS therapies or dietary strategies can be used in combination with the low-FODMAP trial based on IBS subtype and symptom targets [1].
Treatment Initiation and Monitoring Thresholds
The low-FODMAP diet is recommended as a limited trial to improve global IBS symptoms [1]. Serving sizes listed as low-FODMAP in the elimination-phase chart are treated as critical limits [2].
Common Pitfalls to Avoid
Increasing a fruit portion beyond the listed elimination-phase serving size is treated as high FODMAP for that item [2]. Using more than one serving-size-limited low-FODMAP fruit at a single meal or snack is discouraged to avoid cumulative symptom effects [2].
Targets of Therapy
The target of a low-FODMAP trial is improvement in global IBS symptoms [1]. Elimination-phase food targets are met by consuming only listed foods at the listed serving sizes [2].