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The Role of Food Intolerance in Gastrointestinal Disorders

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 January 2024) | Viewed by 11385

Special Issue Editors


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Guest Editor
Division of Gastroenterology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
Interests: neurogastroenterology; gastreoesophageal reflux disease; functional dyspepsia; irritable bowel syndrome; nutrition

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Guest Editor
Department of Surgery, Oncological and Gastrointestinal Science, University of Padova, 35121 Padova, Italy
Interests: neuro-gastroenterology; motility; high-resolution manometry; reflux monitoring; irritable bowel syndrome; inflammatory bowel diseases; eosinophilic gastrointestinal disorders; functional dyspepsia; postprandial distress syndrome
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Special Issue Information

Dear Colleagues,

Food intolerances arise when the body cannot properly digest certain foods. This phenomenon is non-immunological and is often associated with disorders of gut–brain interaction (DGBI), including irritable bowel syndrome (IBS), functional dyspepsia, functional diarrhea, as well as gastroesophageal reflux disease.

Foods commonly associated with food intolerance include milk, gluten, food colorings and preservatives, sulphites, fermentable carbohydrates (FODMAP), and other compounds, such as caffeine and fructose. In addition, even in the absence of clear food intolerance, many patients may complain of food-induced gastrointestinal symptoms, raising the possibility that other more complex factors are involved in symptom generation.

Food intolerance has a significant negative impact on quality of life. Cures for food intolerances are important for patients suffering from gastrointestinal disorders. Emerging evidence shows that a low-FODMAP diet alleviates symptoms in patients with irritable bowel syndrome. Exclusion diets are also used for as short a time as possible to induce symptom improvement and should be followed by gradual food reintroduction to establish individual tolerance.

This Special Issue provides a platform for researchers to discuss the role of food intolerance in gastrointestinal disorders and the cures for food intolerance, with the aim of helping to promote the development of this field.  In the present Special Issue, we welcome original articles as well as narrative and systematic reviews.

Dr. Giovanni Sarnelli
Dr. Edoardo V. Savarino
Guest Editors

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Keywords

  • food intolerance
  • gastrointestinal disorders
  • fermentable carbohydrates
  • FODMAP
  • DGBI
  • low-FODMAP diet
  • exclusion diet
  • lactose and milk intolerance
  • gluten-free diet
  • nickel
  • postprandial distress syndrome

Published Papers (3 papers)

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Review

21 pages, 1456 KiB  
Review
Food Intolerances, Food Allergies and IBS: Lights and Shadows
by Andrea Pasta, Elena Formisano, Francesco Calabrese, Maria Corina Plaz Torres, Giorgia Bodini, Elisa Marabotto, Livia Pisciotta, Edoardo Giovanni Giannini and Manuele Furnari
Nutrients 2024, 16(2), 265; https://doi.org/10.3390/nu16020265 - 16 Jan 2024
Cited by 1 | Viewed by 2850
Abstract
This narrative review delves into the intricate relationship between irritable bowel syndrome (IBS) and food intolerances. IBS, a chronic functional gastrointestinal disorder, is characterized by symptoms like abdominal pain and altered bowel habits. The prevalence of IBS has increased globally, especially among young [...] Read more.
This narrative review delves into the intricate relationship between irritable bowel syndrome (IBS) and food intolerances. IBS, a chronic functional gastrointestinal disorder, is characterized by symptoms like abdominal pain and altered bowel habits. The prevalence of IBS has increased globally, especially among young adults. Food and dietary habits play a crucial role in IBS management. About 85–90% of IBS patients report symptom exacerbation linked to specific food consumption, highlighting the strong connection between food intolerances and IBS. Food intolerances often exhibit a dose-dependent pattern, posing a challenge in identifying trigger foods. This issue is further complicated by the complex nature of gastrointestinal physiology and varying food compositions. This review discusses various dietary patterns and their impact on IBS, including the low-FODMAP diet, gluten-free diet, and Mediterranean diet. It highlights the importance of a personalized approach in dietary management, considering individual symptom variability and dietary history. In conclusion, this review emphasizes the need for accurate diagnosis and holistic management of IBS, considering the complex interplay between dietary factors and gastrointestinal pathophysiology. It underlines the importance of patient education and adherence to treatment plans, acknowledging the challenges posed by the variability in dietary triggers and the psychological impact of dietary restrictions. Full article
(This article belongs to the Special Issue The Role of Food Intolerance in Gastrointestinal Disorders)
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14 pages, 640 KiB  
Review
Nutrition and Disorders of Gut–Brain Interaction
by Emidio Scarpellini, Lukas Michaja Balsiger, Bert Broeders, Karen Van Den Houte, Karen Routhiaux, Karlien Raymenants, Florencia Carbone and Jan Tack
Nutrients 2024, 16(1), 176; https://doi.org/10.3390/nu16010176 - 4 Jan 2024
Cited by 2 | Viewed by 2490
Abstract
Background: Disorders of gut–brain interaction (DGBIs) have a complex pathophysiology that is often characterized by a relationship between food ingestion and triggering of symptoms. Understanding of the underlying mechanisms and the role of nutrients as a therapeutic target are rapidly evolving. Aims and [...] Read more.
Background: Disorders of gut–brain interaction (DGBIs) have a complex pathophysiology that is often characterized by a relationship between food ingestion and triggering of symptoms. Understanding of the underlying mechanisms and the role of nutrients as a therapeutic target are rapidly evolving. Aims and methods: We performed a narrative review of the literature using the following keywords, their acronyms, and their associations: nutrients, disorders of gut–brain interaction; functional dyspepsia; malabsorption; irritable bowel syndrome; diarrhea; constipation. Results: Functional dyspepsia displayed a significant correlation between volume, fat and/or wheat abundance, chemical composition of ingested food and symptoms of early satiety, fullness and weight loss. Carbohydrate malabsorption is related to enzyme deficiency throughout the GI tract. Food composition and richness in soluble vs. non-soluble fibers is related to constipation and diarrhea. The elimination of fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) has a significant and non-unidirectional impact on irritable bowel syndrome (IBS) symptoms. Conclusions: Food volume, nutritive and chemical composition, and its malabsorption are associated with symptom generation in DGBIs. Further multicenter, randomized-controlled clinical trials are needed to clarify the underlying pathophysiology. Full article
(This article belongs to the Special Issue The Role of Food Intolerance in Gastrointestinal Disorders)
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26 pages, 5313 KiB  
Review
Myths and Facts about Food Intolerance: A Narrative Review
by Fabiana Zingone, Luisa Bertin, Daria Maniero, Michela Palo, Greta Lorenzon, Brigida Barberio, Carolina Ciacci and Edoardo Vincenzo Savarino
Nutrients 2023, 15(23), 4969; https://doi.org/10.3390/nu15234969 - 30 Nov 2023
Cited by 4 | Viewed by 5508
Abstract
Most adverse reactions to food are patient self-reported and not based on validated tests but nevertheless lead to dietary restrictions, with patients believing that these restrictions will improve their symptoms and quality of life. We aimed to clarify the myths and reality of [...] Read more.
Most adverse reactions to food are patient self-reported and not based on validated tests but nevertheless lead to dietary restrictions, with patients believing that these restrictions will improve their symptoms and quality of life. We aimed to clarify the myths and reality of common food intolerances, giving clinicians a guide on diagnosing and treating these cases. We performed a narrative review of the latest evidence on the widespread food intolerances reported by our patients, giving indications on the clinical presentations, possible tests, and dietary suggestions, and underlining the myths and reality. While lactose intolerance and hereditary fructose intolerance are based on well-defined mechanisms and have validated diagnostic tests, non-coeliac gluten sensitivity and fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) intolerance are mainly based on patients’ reports. Others, like non-hereditary fructose, sorbitol, and histamine intolerance, still need more evidence and often cause unnecessary dietary restrictions. Finally, the main outcome of the present review is that the medical community should work to reduce the spread of unvalidated tests, the leading cause of the problematic management of our patients. Full article
(This article belongs to the Special Issue The Role of Food Intolerance in Gastrointestinal Disorders)
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