A diet low in fermentable carbohydrates (FODMAP) during or after treatment of cancer in the pelvic area

Gastrointestinal problems can be a side effect of the treatment of cancer in the pelvic area. The problems include diarrea, gases and pain. A diet with a low proportion of fermentable carbohydrates (FODMAP) have been examined with regards to other patient populations with similar symptoms. A theory is therefore that a low FODMAP diet can be beneficial to patients suffering from gastrointestinal problems after cancer treatment.

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Responds to queries received from Swedish healthcare and social service providers, or governmental organisations. Queries have a limited scope and the process is designed to enable a more rapid response, typically within two to three months. Reports are based on systematic reviews, that are identified through structured searches and critically appraised for risk of bias.

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Published: Report no: ut202323 Registration no: SBU 2023/386

Question

What systematic reviews and scientific studies have been published regarding the effect of FODMAP on gastrointestinal problems in patients with cancer in the pelvic area?

Method

A systematic literature search was performed using the following databases: Medline (via Ovid), Scopus and Cinahl.

Two authors independently assessed the abstracts of all identified studies.

Identified literature

No relevant systematic reviews were identified. However, two primary studies were identified [1] [2]. Primary studies are not assessed for risk for bias.

References

  1. Soto-Lugo JH, Souto-Del Bosque MA, Vázquez-Martínez CA. Effectiveness of nutritional intervention in reduction of gastrointestinal toxicity during external beam radiotherapy in women with gynecological tumors. Gac Mexicana Oncologia. 2017;16(2). Available from: https://doi.org/10.24875/j.gamo.17000016.
  2. Schaefer C, Zamboglou C, Volegova-Neher N, Martini C, Nicolay NH, Schmidt-Hegemann N-S, et al. Impact of a low FODMAP diet on the amount of rectal gas and rectal volume during radiotherapy in patients with prostate cancer - a prospective pilot study. Radiation oncology (London, England). 2020;15(1). Available from: https://doi.org/https://dx.doi.org/10.1186/s13014-020-1474-y.

Search strategies

Medline via OvidSP 22 June 2023

Title: FODMAP and gastrointestinal problems during cancer rehabilitation.
Search termsItems found
/ = Term from the MeSH controlled vocabulary; .sh = Term from the MeSH controlled vocabulary; exp = Term from MeSH including terms found below this term in the MeSH hierarchy; .ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords; .kw = Keywords, exact; .bt = Book title. NLM Bookshelf.; .pt = Publication type; .ja = Journal abbreviation; .af = All fields; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other.; * or $ = Truncation
“ “ = Citation Marks; searches for an exact phrase
Population:
1. Exp Neoplasms/ 3 844 141
2. Neoplasm*.ti,ab,kf,bt. 311 663
3. Cancer*.ti,ab,kf,bt. 2 249 943
4. Exp Radiotherapy/ 207 149
5. Radiation*.ti,ab,kf,bt. 436 985
6. Radiotherap*.ti,ab,kf,bt. 220 638
7. Exp Antineoplastic agents/ 1 243 637
8. Chemotherap*.ti,ab,kf,bt. 497 198
9. Exp Surgical Oncology/ 777
10. Surger*.ti,ab,kf,bt. 1 501 678
11. Operat*.ti,ab,kf,bt. 1 368 017
12. Oncolog*.ti,ab,kf,bt. 211 114
13. Tumor*.ti,ab,kf,bt. 1 753 331
14. Tumour*.ti,ab,kf,bt. 306 875
15. Carcinom*.ti,ab,kf,bt. 775 350
16. Malignan*.ti,ab,kf,bt. 685 437
Intervention:
17. exp FODMAP Diet/ 10
18. fodmap.ti,ab,kf,bt 656
Combined sets:
19. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 7 786 739
20. 17 OR 18 656
Final result
21. 19 AND 20 18

Scopus via scopus.com 22 June 2023

Title: FODMAP and gastrointestinal problems during cancer rehabilitation.
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields; W/n = Within. Proximity operator retrieving terms within n words from each other.; PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words.; LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range.; DOCTYPE = Publication type; “re” = review; “le” = letter; “ed” = editorial; “ch” = book chapter; “cp” = conference proceedings; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search termsItems found
Population:
1. TITLE-ABS-KEY (cancer*) 3 859 179
2. TITLE-ABS-KEY (neoplasm*) 3nbsp;032nbsp;825
3. TITLE-ABS-KEY (radiotherap*) 486 763
4. TITLE-ABS-KEY (radiation*) 1 943 570
5. TITLE-ABS-KEY (chemotherap*) 901 755
6. TITLE-ABS-KEY (“antineoplastic agent*”) 619 349
7. TITLE-ABS-KEY (surger*) 2 706 567
8. TITLE-ABS-KEY (operat*) 6 051 115
9. TITLE-ABS-KEY (oncolog*) 336 358
10. TITLE-ABS-KEY (tumor*) 3 953 978
11. TITLE-ABS-KEY (tumour*) 366 870
12. TITLE-ABS-KEY (malignan*) 926 339
13. TITLE-ABS-KEY (carcinom*) 1 376 606
Intervention:
14. TITLE-ABS-KEY (fodmap) 1 011
Combined sets:
15. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 14 870 089
Final result
16. 14 AND 15 80

CINAHL via EBSCO 22 June 2023

Title: FODMAP and gastrointestinal problems during cancer rehabilitation.
TI = Title; AB = Abstract; SU = Keyword, exact or part (including all other fields for indexed and author keywords); MH = Exact subject heading, indexed keywords; TX = All text; PT = Publication type; Nn = Near. Proximity operator retrieving terms within n words from each other.; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search termsItems found
Population:
1. (MH "Neoplasms+") 649 524
2. TI neoplasm* OR AB neoplasm* 18 690
3. TI cancer* OR AB cancer* 497 137
4. (MH "Radiotherapy+") 41 264
5. TI radiotherap* OR AB radiotherap* 42 158
6. TI radiation* OR AB radiation* 66 373
7. (MH "Antineoplastic Agents+") 137 623
8. TI "antineoplastic agent*" OR AB "antineoplastic agent*" 664
9. TI chemotherap* OR AB chemotherap* 87 954
10. (MH "Surgery, Operative+") 749 628
11. TI surger* OR AB surger* 308 692
12. TI operat* OR AB operat* 226 941
13. (MH "Oncology+") 12 711
14. TI oncolog* OR AB oncolog* 71 869
15. TI tumor* OR AB tumor* 191 919
16. TI tumour* OR AB tumour* 36 610
17. TI carcinom* OR AB carcinom* 95 339
18. TI malignan* OR AB malignan* 91 039
Intervention:
19. (MH "Low FODMAP Diet") 84
20. TI fodmap OR AB fodmap 359
Combined sets:
21. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 1 777 522
22. 19 OR 20 373
Final result
23. 21 AND 22 14
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