Evidence-Based Diet Strategies

FODMAP Diet

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A low "FODMAP" diet has been shown to reduce gastrointestinal symptoms in people with IBS and functional dyspepsia (Nordin et al., 2022; Potter et al., 2020; van Lanen et al., 2021). FODMAP stands for fermentable oligosaccharide, disaccharide, monosaccharide, and polyol, all of which are carbohydrates that are poorly absorbed in the small intestine (Pesce et al., 2020). Because of their poor absorption, they cause an increase in fluid and gas in the bowel, which can cause bloating, pain, and other gastrointestinal symptoms (Fragkos et al., 2019).

 

FODMAPs can also be found in a variety of everyday foods (Pesce et al., 2020). Based on the work of Chumpitazi et al. (2018), common foods high in FODMAP carbohydrates include potato chips, fries, sweetened beverages (such as Simply Lemonade, Ocean Spray Cranberry Juice, Gold Peak Sweet Tea, Snapple Half n' Half), pretzels, corn chex, and rice chex. In contrast, they identified green beans, broccoli, corn, lettuce, spinach, saltine crackers, brown rice, white rice, mayonnaise, mustard, and peanut butter as foods with a low FODMAP content. Consuming fewer of the FODMAP carbohydrates may help to alleviate gastrointestinal symptoms (Fragkos et al., 2019). 

 

Given the strong link between EDS, IBS, and functional dyspepsia, it has been proposed that a low FODMAP diet may also be beneficial for people with EDS (Choudhary et al., 2021; Lam et al., 2021).

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However, it is important to note that the low FODMAP diet is not a “one size fits all” approach nor a permanent diet (Barrett, 2017). Research suggests that a long-term, low FODMAP diet may lead to inadequate nutrient intake and a large reduction in the gut bacteria that are necessary for proper function (Staudacher, 2017).

 

While diet is a symptom management approach that patients can have more control over, it is important to consult with a dietitian before beginning this diet and throughout the process to ensure safety and success (Barrett, 2017).

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Wheat and Gluten

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Wheat products, specifically the gluten protein, may cause or worsen symptoms in people with functional dyspepsia (Du et al., 2018; Duncanson et al., 2018). However, there is often overlap in foods that are high in FODMAPs and gluten (Duncanson et al., 2018). As a result, the individual effect of gluten on functional dyspepsia symptoms is currently unclear. Nonetheless, a gluten-free diet has been shown to reduce symptoms in some individuals with functional dyspepsia (Potter et al., 2020; Staudacher et al., 2021), and thus may be a beneficial dietary modification.

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Dietary Fats

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Fats have been identified as a significant contributor to functional dyspepsia (Duncanson et al., 2018). It has been demonstrated that a high-fat meal can cause nausea, pain, and a feeling of fullness (Pesce et al., 2017). The primary mechanisms by which fatty foods can aggravate functional dyspepsia symptoms are delayed gastric emptying (slower emptying of food from the stomach) and increased sensitivity to gastrointestinal hormones (Pesce et al., 2017). As a result, reducing the amount of fat consumed may be another beneficial dietary modification.