The reasons are hypersensitivity to luminal distension or a proclivity to excess water retention and gas production and accumulation, but they do not cause intestinal inflammation.
[2][9][11][12] FODMAPs, especially fructans, are present in small amounts in gluten-containing grains and have been identified as a possible cause of symptoms in people with non-celiac gluten sensitivity.
[13] As of 2019, reviews conclude that although FODMAPs present in wheat and related grains may play a role in non-celiac gluten sensitivity, they only explain certain gastrointestinal symptoms, such as bloating, but not the extra-digestive symptoms that people with non-celiac gluten sensitivity may develop, such as neurological disorders, fibromyalgia, psychological disturbances, and dermatitis.
[3][17][13] Consuming a low FODMAP diet without a previous medical evaluation could cause health risks because it can ameliorate and mask digestive symptoms of celiac disease, delaying or avoiding its correct diagnosis and therapy.
[7] Commonly used FODMAPs comprise the following:[21] Sources of fructans include wheat, rye, barley, onion, garlic, Jerusalem and globe artichoke, beetroot, dandelion leaves, the white part of leeks, the white part of spring onion, brussels sprouts, savoy cabbage, and prebiotics such as fructooligosaccharides (FOS), oligofructose and inulin.
[22][failed verification][7][23] Asparagus, fennel, red cabbage, and radicchio contain moderate amounts but may be eaten if the advised portion size is observed.
[26][better source needed][failed verification] Polyols, specifically sugar alcohols, used as artificial sweeteners in commercially prepared food, beverages, and chewing gum, include isomalt, maltitol, mannitol, sorbitol, and xylitol.
[29] Several studies have found a low-FODMAP diet to improve digestive symptoms in adults with irritable bowel syndrome,[8][9][10][11] but its long-term use can have negative effects, because it has a detrimental impact on the gut microbiota and metabolome.
[8] Small studies (which are susceptible to bias) show little evidence of its effectiveness in treating functional symptoms of inflammatory bowel disease (IBD).
Fructan intolerance does not explain the extra-digestive symptoms that people with non-celiac gluten sensitivity may develop, such as neurological disorders, fibromyalgia, psychological disturbances, and dermatitis.