We asked our founding scientist, Shalaka Samant, Ph.D., the one question frequently asked by first-time customers: Is FODZYME a "forever" product, or will our gut eventually be able to tolerate FODMAPs again?

Here's what she said:

"Current research reports that diet is one of the key modulators that shape the gut microbiota composition and the structure of the gut microbiome. It directly influences host homeostasis and biological processes in the GI tract (1,2 )
Evidence shows that an imbalance in the gut microbiota (gut dysbiosis) contributes to the pathogenesis of Irritable Bowel Syndrome (IBS). Pathophysiological changes in IBS can cause maladaptive shifts in the gut microbiota profile (2-4).

A diet low in short-chain fermentable carbohydrates (FODMAPs) is an effective and internationally accepted regimen and the first choice of diet for the management of symptoms in IBS (5).

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Restricting various types of fermentable carbohydrates, such as oligosaccharides (fructans, galacto-oligosaccharides [GOS]), disaccharides (lactose), monosaccharides (fructose when in excess of glucose), and polyols (sorbitol, mannitol), significantly improves GI symptoms in patients with IBS.

However, long-term intake of a low-FODMAP diet is known to adversely affect the intestinal microbiota composition and functions (5, 6).

Despite the known beneficial effects of the low-FODMAP diet for symptom control, some FODMAP categories, such as fructans and GOS, are known to act as prebiotics. Prebiotics (defined as “a substrate that is selectively utilized by the microorganism, conferring a health benefit) promote the maintenance and restoration of beneficial gut organisms, such as the Bifidobacterium and Lactobacillus species (5-7). The low-FODMAP diet can cause nutritional inadequacies and imbalances due to a considerable reduction in the intake of prebiotics such as fructans and GOS (5). Thus, the long-term dietary elimination of all FODMAPs is not recommended in IBS because it can alter the composition and functioning of gut microbiota and cause a reduction in specific bacterial groups (e.g., Bifidobacterium) or the overall microbiota community (8). This can further exacerbate the shift towards a dysbiotic colonic environment.

FODZYME effectively predigests fructan, GOS, and lactose present in regular meals before these FODMAPs can reach the colon - the main site of bacterial fermentation and symptom development. Having achieved symptom control, regular FODZYME users can reintroduce a wider variety of foods and, consequently, prebiotic fiber compared to what they were consuming earlier while on a restrictive low-FODMAP diet. The improved diversity of prebiotic fiber can steadily start providing substrate for the growth of key bacterial groups such as Bifidobacteria that play an important role in gut homeostasis and overall health.

It is thought that microbiota are resilient to change without environmental stressors, which would point towards restoring the initial microbiome once a regular diet is resumed (11). Thus, it is reasonable to hypothesize that as the beneficial bacterial groups flourish and begin repopulating the gut, the existing microbial imbalance (dysbiosis) might start getting corrected. Indeed, compared to a low-FODMAP diet, populations consuming their habitual diet exhibit specific stimulation of the growth of bacterial groups with putative health benefits (9, 10). Additionally, the now abundant, beneficial colonic bacteria that possess the necessary enzymes for digestion of FODMAPs might themselves take up the role of adequately degrading FODMAPs, akin to the process in healthy individuals. It is also possible that the growth of the beneficial microbes reduces that of unfavorable ones, i.e., pathogenic colonization, that leads to symptoms following FODMAP consumption. Thus, regular FODZYME use might eventually lead to establishment of eubiosis (adequate gut microbial balance), obviating the need for continuous FODZYME use."

References:

  1. Rinninella E, Cintoni M, Raoul P, et al. Food components and dietary habits: keys for a healthy gut microbiota composition. Nutrients. 2019;11:2393. doi: 10.3390/nu11102393
  2. Zangara MT, McDonald C. How diet and the microbiome shape health or contribute to disease: a mini-review of current models and clinical studies. Exp Biol Med (Maywood). 2019;244:484-493. doi: 10.1177/1535370219826070
  3. Thursby E, Juge N. Introduction to the human gut microbiota. Biochem J. 2017;474:1823-1836. doi: 10.1042/BCJ20160510
  4. Menees S, Chey W. The gut microbiome and irritable bowel syndrome. F1000Res. 2018;7:F1000 Faculty Rev-1029. doi: 10.12688/f1000research.14592.1
  5. Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017;66:1517-1527. doi: 10.1136/gutjnl-2017-313750
  6. Rinninella E, Tohumcu E, Raoul P, Fiorani M, Cintoni M, Mele MC, Cammarota G, Gasbarrini A, Ianiro G. The role of diet in shaping human gut microbiota. Best Pract Res Clin Gastroenterol. 2023 Feb-Mar;62-63:101828
  7. Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: the International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14:491-502. doi: 10.1038/nrgastro.2017.75
  8. Thomas A, Thomas A, Butler-Sanchez M. Dietary Modification for the Restoration of Gut Microbiome and Management of Symptoms in Irritable Bowel Syndrome. Am J Lifestyle Med. 2021 May 10;16(5):608-621. doi: 10.1177/15598276211012968.
  9. Halmos EP, Christophersen CT, Bird AR, Shepherd SJ, Gibson PR, Muir JG. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut. 2015 Jan;64(1):93-100. doi: 10.1136/gutjnl-2014-307264
  10. Staudacher H, Lomer MCE, Anderson J, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr 2012;142:1510–18.
  11. Walker A.W., Ince J., Duncan S.H., Webster L.M., Holtrop G., Ze X., Brown D., Stares M.D., Scott P., Bergerat A., et al. Dominant and Diet-Responsive Groups of Bacteria within the Human Colonic Microbiota. ISME J. 2011;5:220–230. doi: 10.1038/ismej.2010.118.