Turkiye Klinikleri Journal of Sports Sciences

.: REVIEW
Egzersizle İlişkili Gastrointestinal Problemlerde Düşük FODMAP Diyet Yaklaşımı
Low FODMAP Diet Approach in Exercise-Related Gasrointestinal Problems
Günay ESKİCİa
aÇanakkale Onsekiz Mart Üniversitesi Spor Bilimleri Fakültesi, Antrenörlük Eğitimi Bölümü, Çanakkale, TÜRKİYE
Turkiye Klinikleri J Sports Sci. 2020;12(2):233-40
doi: 10.5336/sportsci.2019-72526
Article Language: TR
Full Text
ÖZET
 Egzersize bağlı olarak gelişen gastrointestinal semptomlar, son yıllarda görülme sıklığı artan, sporcuların sağlığını ve performansını olumsuz etkileyen bir durum olmuştur. Özellikle dayanıklılık sporcularında görülme sıklığı diğer branşlara göre daha fazladır. Sporcular geğirme, mide bulantısı, kusma, mide ekşimesi, şişkinlik ve hatta dışkı inkontinansı (dışkılama kontrol yetisinin bozulması) gibi gastrointestinal sistem (GİS) semptomları yaşayabilir. Yaşanan bu gastrointestinal problemler, irritabl bağırsak sendromu (İBS) yaşayan bireylerin klinik bulgularına benzerdir. Bireylerin beslenme alışkanlıkları ve besin tüketimlerinin bu semptomları artırıcı etkisi olabileceği gibi azaltıcı etki sağlayabileceği de düşünülmektedir. İBS tedavisi için geliştirilmiş olan düşük FODMAP içerikli diyet, kısa zincirli, emilimi sınırlı/düşük karbonhidratlardan olan fermente oligosakkarit, disakkarit, monosakkarit ve polyoller (FODMAP)in sınırlandırıldığı bir diyet olarak tanımlanır. Düşük FODMAP diyetinin, İBS üzerindeki klinik etkisi büyük oranda kanıtlanmış, diyeti uygulayan bireylerde İBS semptomlarında önemli oranda azalma gözlenmiştir. Bu sonuçtan yola çıkarak sporcuların egzersize bağlı yaşadıkları gastrointestinal problemlerde de aynı diyet yaklaşımının olumlu etki yaratacağı düşünülmüştür. FODMAP'ların mekanizmaları ve sporcuların yaşadıkları semptomlar üzerindeki etkileri hâlâ araştırılmaktadır. Ortaya çıkan teori ve kanıtlar, düşük FODMAP diyeti veya kısıtlamasının, sürekli egzersizle ilişkili gastrointestinal sorunlar ile mücadele eden sporculardaki semptomları azaltmada faydalı olabileceğini göstermektedir. Bu derleme, düşük FODMAP içerikli diyet hakkında bilgilendirme yapmak ve egzersizle ilişkili gastrointestinal problemlerdeki etkisini ortaya koymak amacıyla hazırlanmıştır.

Anahtar Kelimeler: FODMAP; gastrointestinal; sporcu; irritabl bağırsak sendromu (İBS)
ABSTRACT
 Exercise-related gastrointestinal symptoms have been an increasing condition in recent years, adversely affecting the health and performance of athletes. Especially in endurance athletes, the incidence is higher than other branches. Athletes may experience gastrointestinal symptoms such as belching, nausea, vomiting, heartburn, bloating, and even fecal incontinence (deterioration of defecation control ability). These gastrointestinal problems are similar to the clinical findings of individuals with Irritable Bowel Syndrome (IBS). It is thought that nutritional habits and food consumption of individuals may have an effect that may increase these symptoms as well as a decrease effect. Diet low FODMAP-containing diet developed for the treatment of IBS is defined as a diet in which fermented oligo-, di- and mono-saccharides and polyols (FODMAP), which are short-chain, limited absorption / low carbohydrates, are restricted. The clinical effect of low FODMAP diet on IBS has been proven to a great extent, and a significant reduction in IBS symptoms has been observed in people on low FODMAP diet. Based on this result, it is thought that the same diet approach will have a positive effect on the gastrointestinal problems of athletes due to exercise. The mechanisms of FODMAPs and their effects on the symptoms experienced by athletes are still under investigation. Emerging theories and evidence suggest that a low FODMAP diet or FODMAP restriction may be useful in reducing symptoms in athletes struggling with gastrointestinal problems associated with continuous exercise. This review aims to provide information about low FODMAP diet and its effects on exercise-related gastrointestinal problems.

Keywords: FODMAP; gastrointestinal; athlete; irritable bowel syndrome (IBS)
REFERENCES:
  1. Waterman JJ, Kapur R. Upper gastrointestinal issues in athletes. Curr Sports Med Rep. 2012;11(2):99-104. [Crossref]  [PubMed] 
  2. Pugh JN, Kirk B, Fearn R, Morton JP, Close GL. Prevalence, severity and potential nutritional causes of gastrointestinal symptoms during a marathon in recreational runners. Nutrients. 2018;10(7):811. [Crossref]  [PubMed]  [PMC] 
  3. Lis DM. Exit gluten‑free and enter low FODMAPs: a novel dietary strategy to reduce gastrointestinal symptoms in athletes. Sports Med. 2019;49(Suppl 1):87-97. [Crossref]  [PubMed]  [PMC] 
  4. Çelebi F, Akbulut G. [Current dietary approaches in bowel diseases: low fermentable oligo-, di- and mono-saccharides and polyols (FODMAP) diet: review]. Turkiye Klinikleri J Gastroenterohepatol. 2014;21(2):43-52. [Crossref] 
  5. Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016;55(3):897-906. [Crossref]  [PubMed] 
  6. Lis DM, Stellingwerff T, Kitic CM, Fell JW, Ahuja KDK. Low FODMAP: a preliminary strategy to reduce gastrointestinal distress in athletes. Med Sci Sports Exerc. 2018;50(1): 116-23. [Crossref]  [PubMed] 
  7. Hewawasam SP, Iacovou M, Muir JG, Gibson PR. Dietary practices and FODMAPs in South Asia: applicability of the low FODMAP diet to patients with irritable bowel syndrome. J Gastroenterol Hepatol. 2018;33(2):365-74. [Crossref]  [PubMed] 
  8. Krogsgaard LR, Lyngesen M, Bytzer P. Systematic review: quality of trials on the symptomatic effects of the low FODMAP diet for irritable bowel syndrome. Aliment Pharmacol Ther. 2017;45(12):1506-13. [Crossref]  [PubMed] 
  9. Priyanka P, Gayam S, Kupec JT. The role of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet in nonceliac gluten sensitivity. Gastroenterol Res Pract. 2018;1561476. [Crossref]  [PubMed]  [PMC] 
  10. Masuy I, Van Oudenhove L, Tack J, Biesiekierski JR. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls. Neurogastroenterol Motil. 2018;30(1). [Crossref]  [PubMed] 
  11. Gibson PR. History of the low FODMAP diet. J Gastroenterol Hepatol. 2017;32 Suppl 1:5-7. [Crossref]  [PubMed] 
  12. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(1):67-75.e5. [Crossref]  [PubMed] 
  13. Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP diet improves irritable bowel syndrome symptoms: a meta-analysis. Nutrients. 2017;9(9):940. [Crossref]  [PubMed]  [PMC] 
  14. Varney J, Barrett J, Scarlata K, Catsos P, Gibson PR, Muir JG. FODMAPs: food composition, defining cutoff values and international application. J Gastroenterol Hepatol. 2017;32 Suppl 1:53-61. [Crossref]  [PubMed] 
  15. Whigham L, Joyce T, Harper G, Irving PM, Staudacher HM, Whelan K, et al. Clinical effectiveness and economic costs of group versus one-to-one education for short-chain fermentable carbohydrate restriction (low FODMAP diet) in the management of irritable bowel syndrome. J Hum Nutr Diet. 2015;28(6):687-96. [Crossref]  [PubMed] 
  16. Zahedi MJ, Behrouz V, Azimi M. Low fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: a randomized controlled trial. J Gastroenterol Hepatol. 2018;33(6): 1192-9. [Crossref]  [PubMed] 
  17. Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach. J Gastroenterol Hepatol. 2010;25(2):252-8. [Crossref]  [PubMed] 
  18. Stuempfle KJ, Hoffman MD. Gastrointestinal distress is common during a 161-km ultramarathon. J Sports Sci. 2015;33(17):1814-21. [Crossref]  [PubMed] 
  19. Ng SC, Lam EFC, Lam TTY, Chan Y, Law W, Tse PCH, et al. Effect of probiotic bacteria on the intestinal microbiota in irritable bowel syndrome. J Gastroenterol Hepatol. 2013;28(10): 1624-31. [Crossref]  [PubMed] 
  20. Catassi G, Lionetti E, Gatti S, Catassi C. The low FODMAP diet: many question marks for a catchy acronym. Nutrients. 2017;9(3):292. [Crossref]  [PubMed]  [PMC] 
  21. Barrett JS. How to institute the low-FODMAP diet. J Gastroenterol Hepatol. 2017;32 Suppl 1:8-10. [Crossref]  [PubMed] 
  22. Brouns F, Delzenne, N, Gibson, G. The dietary fibers- FODMAPs controversy. Cereal Foods World. 2017;62(3):98-103. [Crossref] 
  23. Harper A, Naghibi MM, Garcha D. The role of bacteria, probiotics and diet in irritable bowel syndrome. Foods. 2018;7(2):13. [Crossref]  [PubMed]  [PMC] 
  24. Costa RJS, Snipe R, Camões-Costa V, Scheer V, Murray A. The impact of gastrointestinal symptoms and dermatological injuries on nutritional intake and hydration status during ultramarathon events. Sports Med Open. 2016;2:16. [Crossref]  [PubMed]  [PMC] 
  25. ter Steege RWF, Kolkman JJ, Huisman AB, Geelkerken RH. [Gastrointestinal ischaemia during physical exertion as a cause of gastrointestinal symptoms]. Ned Tijdschr Geneeskd. 2008;152(33):1805-8. [PubMed] 
  26. Lis D, Ahuja KDK, Stellingwerff T, Kitic CM, Fell J. Food avoidance in athletes: FODMAP foods on the list. Appl Physiol Nutr Metab. 2016;41(9):1002-4. [Crossref]  [PubMed] 
  27. Fell J, Lis D, Kitic CM, Ahuja KDK, Stellingwerff T. FODMAP removal in athletes: an online survey of specific food avoidance and associated symptoms in athletes. J Sci Med Sport. 2017;20(1):e9-10. [Crossref] 
  28. Wiffin M, Smith L, Antonio J, Johnstone J, Beasley L, Roberts J. Effect of a short-term low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms. J Int Soc Sports Nutr. 2019;16(1):1. [Crossref]  [PubMed]  [PMC] 
  29. Erickson J, Korczak R, Wang Q, Slavin J. Gastrointestinal tolerance of low FODMAP oral nutrition supplements in healthy human subjects: a randomized controlled trial. Nutr J. 2017;16(1):35. [Crossref]  [PubMed]  [PMC] 
  30. Peters HP, Schep G, Koster DJ, Douwes AC, de Vries WR. Hydrogen breath test as a simple noninvasive method for evaluation of carbohydrate malabsorption during exercise. Eur J Appl Physiol Occup Physiol. 1994;68(5):435-40. [Crossref]  [PubMed] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com