Disclosures The authors declare that they have no conflict of interest.
The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study
Version of Record online: 23 MAY 2013
© 2013 John Wiley & Sons Ltd
International Journal of Clinical Practice
Volume 67, Issue 9, pages 895–903, September 2013
How to Cite
de Roest, R. H., Dobbs, B. R., Chapman, B. A., Batman, B., O'Brien, L. A., Leeper, J. A., Hebblethwaite, C. R. and Gearry, R. B. (2013), The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. International Journal of Clinical Practice, 67: 895–903. doi: 10.1111/ijcp.12128
Linked Comment: www.youtube.com/IJCPeditorial
- Issue online: 16 AUG 2013
- Version of Record online: 23 MAY 2013
- Manuscript Accepted: 1 JAN 2013
- Manuscript Received: 2 JUN 2012
Background and aim
Current treatment for irritable bowel syndrome (IBS) is suboptimal. Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may trigger gastrointestinal symptoms in IBS patients. Our aim was to determine whether a low FODMAP diet improves symptoms in IBS patients.
Irritable bowel syndrome patients, who had performed hydrogen/methane breath testing for fructose and lactose malabsorption and had received dietary advice regarding the low FODMAP diet, were included. The effect of low FODMAP diet was prospectively evaluated using a symptom questionnaire. Furthermore, questions about adherence and satisfaction with symptom improvement, dietary advice and diet were assessed.
Ninety patients with a mean follow up of 15.7 months were studied. Most symptoms including abdominal pain, bloating, flatulence and diarrhoea significantly improved (p < 0.001 for all). 75.6%, 37.8% and 13.3% of patients had fructose, lactose malabsorption or small intestinal bacterial overgrowth respectively. Fructose malabsorption was significantly associated with symptom improvement (abdominal pain odds ratio (OR) 7.09 [95% confidence interval (CI) 2.01–25.0], bloating OR 8.71 (95% CI 2.76–27.5), flatulence OR 7.64 (95% CI 2.53–23.0) and diarrhoea OR 3.39 (95% CI 1.17–9.78), p < 0.029 for all). Most patients (75.6%) were adherent to the diet, which was associated with symptom improvement (abdominal pain, bloating, flatulence and diarrhoea all significantly associated with adherence, r > 0.27, p < 0.011). Most patients (72.1%) were satisfied with their symptoms.
The low FODMAP diet shows efficacy for IBS patients. The current strategy of breath testing and dietary advice provides a good basis to understand and adhere to the diet.