Exclusion Diet (FODMAPs, Gluten-Free)

Presentation

Exclusion diets are therapeutic dietary protocols that temporarily remove certain foods or food groups suspected of causing digestive or systemic symptoms, then methodically reintroduce them to identify individual triggers. These approaches are particularly used in managing irritable bowel syndrome (IBS), food intolerances and non-celiac gluten sensitivity.

Low-FODMAP Diet

Developed by the Monash University team (Australia) under Prof. Peter Gibson and Dr. Sue Shepherd, the low-FODMAP diet is today the most scientifically validated protocol for IBS. FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) are short-chain sugars poorly absorbed in the small intestine and fermented by colon bacteria, causing bloating, gas, abdominal pain and transit disorders.

The protocol follows three phases. The elimination phase (2-6 weeks) removes all FODMAP-rich foods. The reintroduction phase (6-8 weeks) reintroduces each FODMAP subgroup one by one, in increasing doses over 3 days, with 3 "wash-out" days between each test. The personalization phase establishes the long-term adapted diet, removing only individually poorly tolerated FODMAPs.

Gluten-Free Diet

The strict gluten-free diet is the treatment for celiac disease (autoimmune, confirmed by biopsy). For non-celiac gluten sensitivity (NCGS), exclusion is often less strict and an elimination-reintroduction protocol confirms the diagnosis. Alternative grains include rice, buckwheat, quinoa, millet, corn, certified gluten-free oats and teff.

Essential Precautions

Exclusion diets must never be maintained indefinitely without reintroduction: they risk impoverishing the gut microbiome, creating nutritional deficiencies and fostering restrictive eating behaviors. They must be supervised by a trained professional. Prior medical assessment is essential to exclude organic pathology.