Kohlenhydratmalabsorption: Unverträglichkeit fermentierbarer Oligo-, Di-, Monosaccharide und Polyole (FODMAP)
als häufige Ursache unklarer abdomineller Beschwerden (original) (raw)
Dtsch Med Wochenschr 2014; 139(24): 1310-1314
DOI: 10.1055/s-0034-1370108
Übersicht | Review article
Ernährungsmedizin, Gastroenterologie
© Georg Thieme Verlag KG Stuttgart · New York
Malabsorption of fermentable oligo-, di-, or monosaccharides and polyols (FODMAP) as a common cause of unclear abdominal discomfort
M. Goebel-Stengel
1Klinik für Innere Medizin, Martin-Luther Krankenhaus, Berlin
H. Mönnikes
1Klinik für Innere Medizin, Martin-Luther Krankenhaus, Berlin
Further Information
Publication History
16 December 2013
27 March 2014
Publication Date:
03 June 2014 (online)
Zusammenfassung
Die Kohlenhydratmalabsorption ist eine häufige Ursache chronischer gastrointestinaler Beschwerden wie Meteorismus, Flatulenz, Schmerz und Diarrhö. Mittels Wasserstoff- und/oder Methanatemtests nach Ingestion des betreffenden Kohlenhydrats lässt sie sich leicht und zuverlässig identifizieren und anhand konsekutiver erfolgreicher diätetischer Behandlung diagnostizieren. Außer Laktose- und Fruktose können auch andere fermentierbare Oligo-, Di-, und Monosaccharide sowie Polyole (Akronym: FODMAP) abdominelle Beschwerden verursachen. Somit kann nicht nur der Verzehr von Fruktose (hauptsächlich Apfel, Birne, Mango, Wassermelone) und Laktose (Milchprodukte), sondern auch von Galaktanen (Hülsenfrüchte), Fruktanen (Weizen, Zwiebeln, Knoblauch, Artischocken) und der Zuckeraustauschstoffe Sorbitol, Mannitol, Xylitol und Maltitol (zuckerfreie Süßigkeiten, Lightprodukte) diverse abdominale Symptome und Beschwerden auslösen. Eine generelle Reduktion aller FODMAP-Komponenten in der Ernährung kann zu einer signifikanten Linderung funktioneller gastrointestinaler Beschwerden mit verbesserter Lebensqualität führen.
Abstract
Carbohydrate malabsorption is a frequent but underestimated cause of unexplained gastrointestinal symptoms like meteorism, flatulence, pain and diarrhea. By means of hydrogen and/or methane breath test after ingestion of the respective carbohydrate it can be identified and diagnosed easily, fast and reliably by successful nutritional therapy. Besides the well known complaints caused by lactose and fructose malabsorption, other fermentable oligo-, di-, or monosaccharides and polyols (akronym: FODMAP) can cause abdominal discomfort and IBS-like symptoms. In addition to lactose (dairy products) and fructose (apples, pears, mango, watermelon), FODMAPs comprise galactans (legumes), fructans (wheat, onions, garlic, artichoke) and the artificial sweeteners sorbitol, mannitol, maltitol and xylitol (sugar free candy, light products). A general restriction of all FODMAP components can be beneficial in relieving symptoms and improving quality of life in patients with functional gastrointestinal complaints.
Schlüsselwörter
FODMAP - Kohlenhydrate - Malabsorption - ungeklärte abdominelle Beschwerden
Keywords
FODMAP - carbohydrates - malabsorption - unexplained gastrointestinal discomfort
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