Background: FODMAPs (fermentable oligo-, di-, monosaccharides and polyols) are malabsorbed carbohydrates fermented by gut microbiota. Patients suffer bloating, abdominal pain, flatulence and changing of stool consistency, presumably caused by increased osmotic load. Many foods are FODMAP-rich, including legumes, artificial sweeteners and soft drinks. Abdominal pain is common in children referred to the emergency department (ED). Little is known about FODMAPs in children.
Methods: Children who were referred to the ED at Hadassah Mount Scopus Jerusalem with acute abdominal pain from 2014-2016 were surveyed. The families received detailed questionnaires including the child`s daily nutrition, bowel habits, tendency to abdominal pain and its frequency. The investigator documented lab results, imaging and final diagnosis. High FODMAP-containing portions were scored, a total score of >= 19 (range 0-33) was defined as high FODMAP diet.
Results: Out of 116 children aged 6-16 years (80 Arab, 36 Jewish), 31 children reported high FODMAPs content of their diet. Children with FODMAP-rich diet are 2.5 times more likely to report having recurrent abdominal pain (P value 0.033, CI 1.1-5.8). Arab children are 3 times more likely to have FODMAP-rich diet (P value 0.042, CI 1.04-8.56), and 2.4 times more likely to report having recurrent abdominal pain (P value 0.04, CI 1.03-5.49). There was no significant correlation between FODMAP-rich diet and age, sex or weight, lab results, imaging or diagnosis. Consuming soft drinks and sweeteners was not significantly correlated with abdominal pain.
Conclusion: FODMAP-rich diet may cause abdominal pain in children especially of Arab origin. This finding may influence their management, both at the ED and clinic, with special consideration of cultural and socioeconomic aspects.
