Patients are best managed by practising dietitians with experience in IBS or low-FODMAP diets. This is because of the individualised nature of the diet and the potential for nutritional deficiencies. GPs, however, can provide general information on the concept of low FODMAP diets and direct people to the Monash University webpages for additional information (see Consumer resources).
Adherence to this diet may be difficult for approximately 30% of patients with an IBS that is potentially linked to FODMAPs. Conversely, convincing adherent patients who have not responded to stop the low-FODMAP diet can also be difficult.
Assessing lactose absorption using hydrogen-breath-testing may help to distinguish those patients whose IBS is associated with lactose intolerance. Hydrogen-breath testing, however, is not recommended for guiding clinical decisions relating to any other FODMAP.