Gastrointestinal Manifestations and Low- FODMAP Protocol in a Cohort of Fabry Disease Adult Patients

Fabry disease (FD) is an X-linked lysosomal disorder caused by α-galactosidase A enzyme deficiency. Gastrointestinal (GI) manifestations are reported in FD with a prevalence of about 50%, usually treated by Enzymatic Replacement Therapy (ERT) or oral treatment. Since FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) can be involved in GI manifestations and dysbiosis in FD patients, a low-FODMAP diet could represent an alternative adjunctive treatment in FD subjects, as well as being useful for reducing symptoms in Irritable Bowel Syndrome (IBS). Data from 36 adult FD patients followed at the Inherited Metabolic Rare Diseases Adult Centre of the University Hospital of Padova is retrospectively assessed. In symptomatic patients, the low-FODMAP diet is proposed in order to improve GI manifestations. Severe or moderate GI symptoms are to be  found in 61.1% of patients, with no correlation to the therapy in use, and significantly more severe in the classical form of FD. The low-FODMAP diet significantly improves indigestion, diarrhoea, and constipation. This dietetic protocol seems to have a positive impact on intestinal symptoms, by identifying and reducing the intake of the foods most related to the onset of disorders and improving the clinical manifestations. A low-FODMAP diet may be an effective alternative approach to improve intestinal manifestations and quality of life, and nutrition can play an important role in the multidisciplinary care of patients with FD. Read the full article here.