The Distinctive Nutritional Requirements for People with FD

In the absence of a known, organic cause, it is thought that Functional Dyspepsia is associated with the disruption in the lining of the gut1,2.

People with FD often do not eat regularly or normally. This may affect their normal intake of food nutrients.

Recent studies have implicated perturbations of GI microbiota, altered mucosal permeability and abnormal mucosal defense mechanisms in the pathogenesis of some FGIDs3-8.

The uptake (i.e. the digestion of food and absorption of nutrients), is affected due to disturbances in the GI tract. For example, vitamin B12 and folate deficiencies have been observed in the FD population9.

Over 90% of nutrient digestion and absorption takes place in the small intestine10. With FD, this digestive and absorptive process is disrupted in several ways. The bile acid flow is disrupted as part of the FGIDs cascade of disruption11. Peppermint oil (primary component: l-Menthol) helps restore secretory function such as bile flow12. This and other known activities of peppermint oil are helpful in digestion and absorption. Additionally, caraway oil adds to l-Menthol's anti-spasmodic action.

Dietary modification alone, as a management strategy, has had mixed success especially with long-term adherence13. Exclusionary diets help in the short term but may lead to nutritional imbalances and adherence issues in the long-term14 . Fiber and relaxation techniques can be helpful, but may not be enough.

Now doctors increasingly use medical foods, such as FDgard, to help normalize the intake and uptake (i.e. the digestion and absorption of food nutrients), and to help manage FD symptoms.

FDgard is specifically formulated to support the distinctive nutritional requirements of FD that cannot be met with dietary modification alone. By supporting gut health in the first place, FDgard helps avoid nutritional problems downstream. Talk to your doctor about #1 GE recommended FDgard.

1 Stanghellini V, Chan FKL, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology. 2016; 150 (6): Elsevier, Inc: 1380–92.doi:10.1053/j.gastro.2016.02.011.

2 Vanheel H, Vicario M, Vanuytsel T, et al. Impaired duodenal mucosal integrity and low-grade inflammation in functional dyspepsia. Gut. 2014;63(2):262-271. doi:10.1136/gutjnl-2012-303857

3 Kassinen A, Krogius-Kurikka L, Makivuokko H, et al., The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subject. Gastroenterology 2007; 133:24-33.

4 Annahazi A, Ferrier L, Bezirard V, et al. Luminal cysteine-proteases degrade colonic tight junction structure and are responsible for andominal pain in constipation-predominant IBS. Am J Gastroenterol 2013; 108:1322-31.

5 Lee H, Park JH, Park DI, et al. Mucosal mast cell count is associated with intestinal permeability in patients with diarrhea predominant irritable bowel syndrome. Neurogastroenterol Motil 2013; 19:244-50.

6 Matricon J, Meleine M, Gelot A, et al. Review article: associations between immune activation, intestinal permeability and the irritable bowel syndrome. Aliment Pharmacol Ther 2012; 36:1009-31.

7 Vanheel H, Vicario M, Vanuytsel T, et al. Impaired duodenal mucosal integrity and low-grade inflammation in functional dyspepsia. Gut 63 2014: 262-271; doi:10.1136/gutjnl-2012-303857.

8 Martinez C, Lobo B, Pigrau M, et al. Diarrhoea-predominant irritable bowel syndrome: an organic disorder with structural abnormalities in the jejunal epithelial barrier. Gut 2012; 62:1160-8.

9 Rasool, Shahid, Shahab Abid, Mohammad Perwaiz Iqbal, Naseema Mehboobali, Ghulam Haider, and Wasim Jafri. 2012. “Relationship between Vitamin B12, Folate and Homocysteine Levels and H. Pylori Infection in Patients with Functional Dyspepsia: A Cross-Section Study.” BMC Research Notes 5 (1): 206. doi:10.1186/1756-0500-5-206.

10 Dr. Ananya Mandal MD. What Does the Small Intestine Do?

11 Kamath, P.S. et al., abnormal gallbladder motility in irritable bowel syndrome: evidence for target-organ defect. Am J Physiol 260:G815-G819, 1991.

12 Zong, L. et al., Preliminary experimental research on the mechanism of liver  bile secretion stimulated by peppermint oil. J Dig Dis. 2011 Aug: 12(4):295-301.

13 Feinle-Bisset C, Azpiroz F. Dietary and lifestyle factors in functional dyspepsia. Nat Rev Gastroenterol Hepatol. 2013;10(3):150-157. doi:10.1038/nrgastro.2012.246.