Evidence map›Paper›PMID 41953381›Full record

ArticleGastro hep advances2026

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Reintroduction in Clinical Practice: Surveying the Gaps and Opportunities.

Kate Pelletier, Megan Villarreal, Rowan Klar, William D Chey, Prashant Singh, Allen Lee, Yen-Po Wang, Amanda Lynett

Abstract read
In one paragraph

Article in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kate PelletierDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Megan VillarrealDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Rowan KlarDepartment of Umich School of Public Health, Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
William D CheyDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Prashant SinghDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Allen LeeDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Yen-Po WangDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.
Amanda LynettDivision of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan.

Funding

A Systems Biology Approach Using Fecal Microbiota and Metabolomics to Identify Novel Subtypes in Irritable Bowel Syndrome.K23DK124567 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LEE, ALLEN A · 2021 to 2023
$729k
The role of sulfidogenic microbes in quiescent Crohn’s disease with persistent symptomsR03DK139095 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LEE, ALLEN A · 2024 to 2025
$234k
NIDDK NIH HHS K23 DK124567NIDDK NIH HHS R03 DK139095
6 · The paper itself

Abstract

Background and Aims: The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (LFD) consists of 3 phases: restriction, reintroduction, and personalization. Despite the importance of the reintroduction phase, there are limited real-world data on its implementation. This study examined variations in registered dietitians' (RDs) practices during LFD reintroduction. Methods: Cross-sectional national online surveys were conducted. One hundred forty-five RDs were recruited via professional networks, social media, and listservs. Survey questions assessed food dosage at initiation, progression, challenge doses, number of foods tested per subtype, and reintroduction duration. Results: Participants worked in private practice (50%) and academic hospitals (26%). Over half of RDs challenge 1 food per fermentable oligosaccharides, disaccharides, monosaccharides, and polyols group, while 37% use 2 or more. Reintroduction sequencing is typically collaborative (73%), though some RDs leave it to patients. In the absence of symptoms, most wait 1-3 days before increasing doses, while 20% wait over 4 days. When symptoms occur, challenge timing is adjusted based on severity, though 37% follow fixed intervals. Nearly, all RDs (98%) conduct reintroductions one-on-one, with 63% completing them within 1-2 months and 37% taking longer. While the reintroduction practices patterns were similar between academic and nonacademic settings, academic RDs met with patients less frequently during reintroduction phase but more likely to meet with patients after reintroduction compared to nonacademic RDs ( Conclusion: The variability in LFD reintroduction practices underscores the need for a standardized protocol. While most dietitians offer one-on-one sessions and follow-up care, inconsistencies in timing, frequency, and sequencing persist. Although shared decision-making is common, approaches to managing reactions and determining challenge timing vary, highlighting the need for clearer guidelines.

Indexed as

DietitiansIrritable Bowel SyndromeLow FODMAP DietReintroduction Phase

Identifiers

PMID41953381
PMCPMC13054409

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.