Kohlenhydratmalabsorption: Unverträglichkeit fermentierbarer Oligo-, Di-, Monosaccharide und Polyole (FODMAP) als häufige Ursache unklarer abdomineller Beschwerden

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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