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- W2989662807 abstract "We thank Dr Peter Gibson and colleagues for their interest in our study1Huaman J.W. et al.Gastroenterology. 2018; 155: 1004-1007Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar and appreciate their point of view in defense of the low FODMAP diet they so fervently promulgate. Their 3 main concerns are allayed by the following information.1.The Mediterranean diet is the habitual (placebo) diet for the local population in our area (Barcelona).2.Xylose is the substrate of the xylose breath test for the evaluation of small bowel absorption in routine clinical practice; under normal conditions, xylose is completely absorbed in the small bowel without colonic fermentation and detectable gas production. To note, the dose of xylose for the breath test is 25 g, 10 times higher than the 2.4 g used in our study. Indeed, xylose did not hamper the effect of the low FODMAP diet; patients consistently reported symptom relief while on low FODMAP plus xylose. The rebound of symptoms was experienced after discontinuation of the intervention, with no xylose intake in that period.3.The therapeutic advantage is for the patients to decide whether they prefer to continue long-term dietary restrictions (caution: with possible damage to their microbiota) or to follow their habitual diet with a prebiotic supplement. In support of Dr Gibson’s concerns, we acknowledge that this a pilot, proof-of-concept study that needs to be confirmed by a larger and longer, multicenter trial. Furthermore, it remains to be established whether the prebiotic will also work with the local diet in other geographical areas (where the Mediterranean diet is not habitual) and whether this is a product-specific effect or common to other prebiotics. Prebiotics Versus Low FODMAP Diet: An Interpretative NightmareGastroenterologyVol. 156Issue 4PreviewThe concept that prebiotics may assist in the management of functional gastrointestinal symptoms has appeal, and the results and conclusions of a recent clinical trial by Huanan et al claim to support the use of a synthetic prebiotic supplement, β-galacto-oligosaccharide (GOS), for symptom alleviation and microbiota enrichment in patients with chronic functional gastrointestinal symptoms.1 The study was intended to compare the effects of a low FODMAP diet with prebiotic-supplemented support. However, major issues with study design and interpretation require exploration before the results and conclusions are accepted. Full-Text PDF" @default.
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- W2989662807 date "2019-03-01" @default.
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- W2989662807 title "Reply" @default.
- W2989662807 doi "https://doi.org/10.1053/j.gastro.2019.02.026" @default.
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