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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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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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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