scholarly journals Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome

2017 ◽  
Vol 30 (1) ◽  
pp. e13154 ◽  
Author(s):  
M. O'Keeffe ◽  
C. Jansen ◽  
L. Martin ◽  
M. Williams ◽  
L. Seamark ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Dietary Intake ◽  
Healthcare Utilization ◽  
Gastrointestinal Symptoms ◽  
Patient Acceptability ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Long Term Impact

Applying a Low-FODMAP Dietary Intervention to a Female Ultraendurance Runner With Irritable Bowel Syndrome During a Multistage Ultramarathon

2019 ◽  
Vol 29 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Stephanie K. Gaskell ◽  
Ricardo J.S. Costa
Keyword(s):  
Irritable Bowel Syndrome ◽  
Dietary Intervention ◽  
Gastrointestinal Symptoms ◽  
Irritable Bowel Syndrome Symptom ◽  
Carbohydrate Intake ◽  
Severe Nausea ◽  
Dietary Analysis ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
The Impact

Malabsorption of fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) in response to prolonged exercise may increase incidence of upper and lower gastrointestinal symptoms (GIS), which are known to impair exercise performance. This case study aimed to explore the impact of a low-FODMAP diet on exercise-associated GIS in a female ultraendurance runner diagnosed with irritable bowel syndrome, competing in a 6-day 186.7-km mountainous multistage ultramarathon (MSUM). Irritable bowel syndrome symptom severity score at diagnosis was 410 and following a low-FODMAP diet (3.9 g FODMAPs/day) it reduced to 70. The diet was applied 6 days before (i.e., lead-in diet), and maintained during (5.1 g FODMAPs/day) the MSUM. Nutrition intake was analyzed through dietary analysis software. A validated 100-mm visual analog scale quantified GIS incidence and severity. GIS were modest during the MSUM (overall mean ± SD: bloating 27 ± 5 mm and flatulence 23 ± 8 mm), except severe nausea (67 ± 14 mm) experienced throughout. Total daily energy (11.7 ± 1.6 MJ/day) intake did not meet estimated energy requirements (range: 13.9–17.9 MJ/day). Total daily protein [1.4 ± 0.3 g·kg body weight (BW)−1·day−1], carbohydrate (9.1 ± 1.3 g·kg BW−1·day−1), fat (1.1 ± 0.2 g·kg BW−1·day−1), and water (78.7 ± 6.4 ml·kg BW−1·day−1) intakes satisfied current consensus guidelines, except for carbohydrates. Carbohydrate intake during running failed to meet recommendations (43 ± 9 g/hr). The runner successfully implemented a low-FODMAP diet and completed the MSUM with minimal GIS. However, suboptimal energy and carbohydrate intake occurred, potentially exacerbated by nausea associated with running at altitude.

scholarly journals A Low-FODMAP Diet for Irritable Bowel Syndrome: Some Answers to the Doubts from a Long-Term Follow-Up

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2360 ◽  
Author(s):  
Massimo Bellini ◽  
Sara Tonarelli ◽  
Federico Barracca ◽  
Riccardo Morganti ◽  
Andrea Pancetti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Nutritional Adequacy ◽  
Related Quality ◽  
Short And Long Term ◽  
Irritable Bowel ◽  
Fodmap Diet

A low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet (LFD) is a possible therapy for irritable bowel syndrome (IBS). This study investigates the short- and long-term efficacy and nutritional adequacy of an LFD and the patients’ long-term acceptability. Patients’ adherence and ability to perceive the “trigger” foods were also evaluated. Seventy-three IBS patients were given an LFD (T0) and after 2 months (T1), 68 started the reintroduction phase. At the end of this period (T2), 59 were advised to go on an Adapted Low-FODMAP Diet (AdLFD) and 41 were evaluated again after a 6–24 month follow-up (T3). At each time, questionnaires and Biolectrical Impedance Vector Analysis (BIVA) were performed. The LFD was effective in controlling digestive symptoms both in the short- and long-term, and in improving quality of life, anxiety and depression, even if some problems regarding acceptability were reported and adherence decreased in the long term. The LFD improved the food-related quality of life without affecting nutritional adequacy. When data collected at T0 were compared with those collected at T2, the perception of trigger foods was quite different. Even if some problems of acceptability and adherence are reported, an LFD is nutritionally adequate and effective in improving IBS symptoms also in the long term.

Long‐term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome

2021 ◽  
Author(s):  
Heidi M. Staudacher ◽  
Megan Rossi ◽  
Thomas Kaminski ◽  
Eirini Dimidi ◽  
Frances S. E. Ralph ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Irritable Bowel ◽  
Fodmap Diet

scholarly journals Effectiveness and applicability of low FODMAP diet in the irritable bowel syndrome: Preliminary results of a prospective study

2019 ◽  
pp. 4-9
Keyword(s):  
Irritable Bowel Syndrome ◽  
Prospective Study ◽  
Life Quality ◽  
Treatment Efficiency ◽  
Therapeutic Modalities ◽  
Frequency Survey ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
A Prospective Study

Abstract: Introduction: Irritable bowel syndrome (IBS) is a very common entity that alters patient’s life quality worldwide. Several therapeutic modalities are available with variable results. Recently, the low-FODMAP diet effect on IBS symptoms has been proven. The aim of our study was to study the efficiency of this diet and to assess its applicability in a Tunisian IBS group of patients. Methods: A longitudinal, prospective study including 34 patients with IBS was conducted. Patients responded to a food frequency survey and had to follow a low FODMAP diet with a dietary guide education for 3 weeks. After the diet, a telephone questionnaire was conducted to evaluate adherence and treatment efficiency. Results: Mean of the population age was 56.5 (21 – 83 years) with a sex ratio of almost 1⁄4. The initial food survey showed a large consumption of white bread and fruits. Tolerance to rich in FODMAP foods was variable among patients. Up to 97% of patients adhered to the low FODMAP diet. A decrease in abdominal pain in 88% of cases and in bloating in 64.7% of cases (p = 0.007) were noted after the diet. Conclusion: In our patients, the low FODMAP diet showed satisfactory results with good adherence, and improvement of IBS symptoms. However, it is important to note the difficulty of a long-term diet in a population with a variable alimentary habit. Key words: low FODMAP diet; irritable bowel syndrome, applicability, Tunisia

scholarly journals Effectiveness of Two Dietary Approaches on the Quality of Life and Gastrointestinal Symptoms of Individuals with Irritable Bowel Syndrome

2020 ◽  
Vol 9 (1) ◽  
pp. 125 ◽  
Author(s):  
Maria Margarida Guerreiro ◽  
Zélia Santos ◽  
Elisabete Carolino ◽  
Julieta Correa ◽  
Marilia Cravo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Irritable Bowel Syndrome ◽  
Gastrointestinal Symptoms ◽  
Standard Diet ◽  
Before And After ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Third Moment

To evaluate the effectiveness of a low FODMAP (fermentable oligosaccharides, monosaccharaides, disaccharides and polyols) diet in the relief of symptoms and an improvement of the quality of life in individuals with irritable bowel syndrome in comparison to a standard diet according to the British Dietetic Association’s guidelines. A non-randomized clinical trial of adult patients with IBS was compared two diet interventions. An assessment of symptoms, quality of life, and nutritional status was performed before and after the four-week mark of intervention. Individuals from the Low FODMAP Diet (LFD) group were evaluated on a third moment, after the controlled reintroduction of FODMAPs. A total of 70 individuals were divided in two groups: Low FODMAP Diet (LFD; n = 47) and Standard Diet (SD; n = 23). 57 individuals completed the four-week intervention (LFD; n = 39; SD; n = 18). At the completion of four weeks, the symptoms improved in both groups (LFD: p < 0.01; DC: p < 0.05) but LFD led to a higher relief (p < 0.05), primarily with respect to abdominal pain and diarrhoea. Quality of life improved significantly in both groups, with no significant differences between SD vs LFD (p > 0.05). In the LFD group, the relief of symptoms observed at the four-week mark remained constant after reintroduction of FODMAPs. Both interventions seem to be effective for the relief of symptoms and quality of life, however LFD had higher effectiveness in the former. The results with LFD suggest it can be a preferred approach in individuals with diarrhoeal profile.

scholarly journals Long-Term Effects of a Web-Based Low-FODMAP Diet Versus Probiotic Treatment for Irritable Bowel Syndrome, Including Shotgun Analyses of Microbiota: Randomized, Double-Crossover Clinical Trial

10.2196/30291 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e30291
Author(s):  
Dorit Vedel Ankersen ◽  
Petra Weimers ◽  
Mette Bennedsen ◽  
Anne Birgitte Haaber ◽  
Eva Lund Fjordside ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Web Application ◽  
Metagenomic Sequencing ◽  
Web Based ◽  
Probiotic Treatment ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Term Management ◽  
The Web

Background The long-term management of irritable bowel syndrome (IBS) poses many challenges. In short-term studies, eHealth interventions have been demonstrated to be safe and practical for at-home monitoring of the effects of probiotic treatments and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). IBS has been linked to alterations in the microbiota. Objective The aim of this study was to determine whether a web-based low-FODMAP diet (LFD) intervention and probiotic treatment were equally good at reducing IBS symptoms, and whether the response to treatments could be explained by patients’ microbiota. Methods Adult IBS patients were enrolled in an open-label, randomized crossover trial (for nonresponders) with 1 year of follow-up using the web application IBS Constant Care (IBS CC). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Denmark. Patients received either VSL#3 for 4 weeks (2 × 450 billion colony-forming units per day) or were placed on an LFD for 4 weeks. Patients responding to the LFD were reintroduced to foods high in FODMAPs, and probiotic responders received treatments whenever they experienced a flare-up of symptoms. Treatment response and symptom flare-ups were defined as a reduction or increase, respectively, of at least 50 points on the IBS Severity Scoring System (IBS-SSS). Web-based ward rounds were performed daily by the study investigator. Fecal microbiota were analyzed by shotgun metagenomic sequencing (at least 10 million 2 × 100 bp paired-end sequencing reads per sample). Results A total of 34 IBS patients without comorbidities and 6 healthy controls were enrolled in the study. Taken from participating subjects, 180 fecal samples were analyzed for their microbiota composition. Out of 21 IBS patients, 12 (57%) responded to the LFD and 8 (38%) completed the reintroduction of FODMAPs. Out of 21 patients, 13 (62%) responded to their first treatment of VSL#3 and 7 (33%) responded to multiple VSL#3 treatments. A median of 3 (IQR 2.25-3.75) probiotic treatments were needed for sustained symptom control. LFD responders were reintroduced to a median of 14.50 (IQR 7.25-21.75) high-FODMAP items. No significant difference in the median reduction of IBS-SSS for LFD versus probiotic responders was observed, where for LFD it was –126.50 (IQR –196.75 to –76.75) and for VSL#3 it was –130.00 (IQR –211.00 to –70.50; P>.99). Responses to either of the two treatments were not able to be predicted using patients’ microbiota. Conclusions The web-based LFD intervention and probiotic treatment were equally efficacious in managing IBS symptoms. The response to treatments could not be explained by the composition of the microbiota. The IBS CC web application was shown to be practical, safe, and useful for clinical decision making in the long-term management of IBS. Although this study was underpowered, findings from this study warrant further research in a larger sample of patients with IBS to confirm these long-term outcomes. Trial Registration ClinicalTrials.gov NCT03586622; https://clinicaltrials.gov/ct2/show/NCT03586622

scholarly journals The low-FODMAP diet as an effective tool for managing irritable bowel syndrome – an assessment of adult patients’ knowledge of dietary guidelines

2021 ◽  
pp. 419-426
Keyword(s):  
Irritable Bowel Syndrome ◽  
Support Groups ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Disorder ◽  
Elimination Diet ◽  
Dietary Guidelines ◽  
Abdominal Symptoms ◽  
Treatment Objective ◽  
Irritable Bowel ◽  
Fodmap Diet

Background. Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder that is driven by the gutbrain axis and affects 1-20% of the population. Most patients note that various foods elicit abdominal symptoms, and they eliminate these products from their diets. A diet that is low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is currently one of the mainstays in IBS treatment. Objective. The aim of this study was to assess the knowledge of IBS patients about the disease, treatment and the principles of the low-FODMAP diet that can alleviate gastrointestinal symptoms. Material and methods. The participants were adults diagnosed with IBS, the inclusion criteria were: absence of comorbidities requiring an elimination diet, age over 18 years, and consent to participate in the study. The respondents filled out an anonymous questionnaire containing questions about the IBS diagnosis, disease history and treatment, as well as 45 questions assessing the participants’ knowledge about the low-FODMAP diet. Results. In 28% of the cases, IBS was diagnosed by a general practitioner; in nearly 40% of the cases – by a gastroenterology specialist; in 10% of the cases – by a dietitian, whereas the remaining respondents had arrived at the diagnosis independently or with the help of support groups for IBS patients. After diagnosis, only every fourth respondent sought treatment in a gastroenterology clinic. In the studied population, 237 of the respondents had followed to the low-FODMAP diet, and the differentiating factors were sex (p=0.002), place of residence (city with a population higher than 100,000 vs. rural area; p=0.0001) and education (university vs. vocational school p=0.0043). Respondents who had been recently diagnosed with IBS (less than 12 months vs. more than 12 months before the study) were more likely to follow the FODMAP diet. Conclusions. The surveyed population was characterized by high levels of knowledge about the low-FODMAP diet, but many respondents did not strictly comply with dietary guidelines, in particular the duration of each dietary phase. Age was significantly correlated with the respondents’ knowledge, and the participants’ familiarity with low-FODMAP guidelines decreased with age. Nutritional consultations did not significantly improve the respondents’ knowledge about the low-FODMAP diet.

scholarly journals Long-Term Effects of a Web-Based Low-FODMAP Diet Versus Probiotic Treatment for Irritable Bowel Syndrome, Including Shotgun Analyses of Microbiota: Randomized, Double-Crossover Clinical Trial (Preprint)

2021 ◽  
Author(s):  
Dorit Vedel Ankersen ◽  
Petra Weimers ◽  
Mette Bennedsen ◽  
Anne Birgitte Haaber ◽  
Eva Lund Fjordside ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Web Application ◽  
Metagenomic Sequencing ◽  
Web Based ◽  
Probiotic Treatment ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Term Management ◽  
The Web

BACKGROUND The long-term management of irritable bowel syndrome (IBS) poses many challenges. In short-term studies, eHealth interventions have been demonstrated to be safe and practical for at-home monitoring of the effects of probiotic treatments and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). IBS has been linked to alterations in the microbiota. OBJECTIVE The aim of this study was to determine whether a web-based low-FODMAP diet (LFD) intervention and probiotic treatment were equally good at reducing IBS symptoms, and whether the response to treatments could be explained by patients’ microbiota. METHODS Adult IBS patients were enrolled in an open-label, randomized crossover trial (for nonresponders) with 1 year of follow-up using the web application IBS Constant Care (IBS CC). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Denmark. Patients received either VSL#3 for 4 weeks (2 × 450 billion colony-forming units per day) or were placed on an LFD for 4 weeks. Patients responding to the LFD were reintroduced to foods high in FODMAPs, and probiotic responders received treatments whenever they experienced a flare-up of symptoms. Treatment response and symptom flare-ups were defined as a reduction or increase, respectively, of at least 50 points on the IBS Severity Scoring System (IBS-SSS). Web-based ward rounds were performed daily by the study investigator. Fecal microbiota were analyzed by shotgun metagenomic sequencing (at least 10 million 2 × 100 bp paired-end sequencing reads per sample). RESULTS A total of 34 IBS patients without comorbidities and 6 healthy controls were enrolled in the study. Taken from participating subjects, 180 fecal samples were analyzed for their microbiota composition. Out of 21 IBS patients, 12 (57%) responded to the LFD and 8 (38%) completed the reintroduction of FODMAPs. Out of 21 patients, 13 (62%) responded to their first treatment of VSL#3 and 7 (33%) responded to multiple VSL#3 treatments. A median of 3 (IQR 2.25-3.75) probiotic treatments were needed for sustained symptom control. LFD responders were reintroduced to a median of 14.50 (IQR 7.25-21.75) high-FODMAP items. No significant difference in the median reduction of IBS-SSS for LFD versus probiotic responders was observed, where for LFD it was –126.50 (IQR –196.75 to –76.75) and for VSL#3 it was –130.00 (IQR –211.00 to –70.50; <i>P</i>&gt;.99). Responses to either of the two treatments were not able to be predicted using patients’ microbiota. CONCLUSIONS The web-based LFD intervention and probiotic treatment were equally efficacious in managing IBS symptoms. The response to treatments could not be explained by the composition of the microbiota. The IBS CC web application was shown to be practical, safe, and useful for clinical decision making in the long-term management of IBS. Although this study was underpowered, findings from this study warrant further research in a larger sample of patients with IBS to confirm these long-term outcomes. CLINICALTRIAL ClinicalTrials.gov NCT03586622; https://clinicaltrials.gov/ct2/show/NCT03586622

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