Low FODMAP Diet Is Not Effective in Children with Functional Abdominal Pain: A Randomized Controlled Trial

2020 ◽  
Vol 76 (5) ◽  
pp. 334-344
Author(s):  
Katarzyna Mirosława Boradyn ◽  
Katarzyna Eufemia Przybyłowicz ◽  
Elżbieta Jarocka-Cyrta
Keyword(s):  
Abdominal Pain ◽  
Dietary Intervention ◽  
Rating Scale ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Gastrointestinal Symptoms ◽  
Stool Consistency ◽  
Functional Abdominal Pain ◽  
Abdominal Symptoms ◽  
Fodmap Diet

<b><i>Introduction:</i></b> A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) has been shown to reduce symptoms among adult patients and children with irritable bowel syndrome. There are no studies investigating the effectiveness of the low FODMAP diet in pediatric patients with functional abdominal pain (FAP). <b><i>Objective:</i></b> The study aimed to evaluate the effectiveness of the low FODMAP diet in reducing gastrointestinal symptoms in children with FAP in comparison to the control diet based on the National Institute for Health and Care Excellence (NICE) guidelines<b>.</b> <b><i>Methods:</i></b> Twenty-seven children with diagnosed FAP were randomized to 2 groups. Each group received an intervention: the low FODMAP diet or the diet based on NICE. All food was prepared and delivered by a catering company. Data regarding gastrointestinal symptoms were recorded by participants during the 2-week baseline assessment and 4-week dietary intervention. The frequencies of abdominal pain and stools were reported as a number of events per day. The severity of abdominal pain was assessed using the Wong-Baker FACES Pain Rating Scale. The assessment of stool consistency was based on the Bristol Stool Form Scale. <b><i>Results:</i></b> The tendency toward the improvement in abdominal symptoms was noted in the low FODMAP group but without statistical significance. No significant differences in stool consistency were observed in this group. The NICE group experienced significant reduction in abdominal pain intensity and frequency (<i>p</i> &#x3c; 0.01) and improvement in stool consistency (93% reporting normal stool, <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The results of this pilot study suggest that the low FODMAP diet is not effective in the reduction of symptoms in children with FAP.

scholarly journals Parental Opinion about the Low FODMAP Diet in Dietary Treatment of Children with Functional Abdominal Pain

2020 ◽  
Vol 17 (15) ◽  
pp. 5554
Author(s):  
Katarzyna Mirosława Boradyn ◽  
Elżbieta Jarocka-Cyrta ◽  
Katarzyna Eufemia Przybyłowicz ◽  
Małgorzata Obara-Gołębiowska
Keyword(s):  
Abdominal Pain ◽  
Dietary Intervention ◽  
Gastrointestinal Symptoms ◽  
Dietary Treatment ◽  
Lower Percentage ◽  
Functional Abdominal Pain ◽  
Self Assessment ◽  
Nice Guidelines ◽  
Parental Opinion ◽  
Fodmap Diet

The aim of this study was primarily to evaluate differences between parental opinion about the diet and overall changes in children’s symptoms of functional abdominal pain (FAP) during the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet and National Institute for Health and Care Excellence (NICE) diet. Secondly, this paper examined the agreement between parental perception of children’s symptoms and children’s self-assessment of symptoms during the diet in both treatment groups. Twenty-seven children with diagnosed functional abdominal pain (FAP) were randomized to one of two group, receiving the low FODMAP diet or the diet based on NICE guidelines. Children reported gastrointestinal symptoms at baseline and during the diet. At the end of the intervention, parents assessed their children’s diet and symptoms changes, using Likert scales. The agreement between parental and children assessments of gastrointestinal symptoms was defined as the percentage of compatible answers. In the low FODMAP group a significantly lower percentage of parents (38%) declared that it was easy to follow the diet, compared to the NICE group (57%), (p = 0.017). A high percentage of parents in both groups reported improvement in all symptoms of children during dietary intervention. A high level of agreement was also observed between parental and children’s self-assessment of abdominal pain intensity and frequency. Our research suggests that in parental opinion the low FODMAP diet is as effective as the diet based on NICE guidelines in children with FAP. However, the low FODMAP diet may seem more difficult to follow, and this may have had an impact on the effectiveness and acceptability of the FODMAP diet by children.

scholarly journals Effect of a Low-fodmap Diet for the Management of Functional Abdominal Pain Disorders in Children: A Study Protocol for a Randomized Controlled Trial

2020 ◽  
Author(s):  
Agata Stróżyk ◽  
Andrea Horvath ◽  
Jane Muir ◽  
Hania Szajewska
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Controlled Trial ◽  
Well Being ◽  
World Health ◽  
Reliable Change Index ◽  
Functional Abdominal Pain ◽  
Regular Diet ◽  
Randomized Controlled ◽  
Fodmap Diet

Abstract Background Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared with a regular diet for the management of children with FAPDs. Methods We will perform a randomized, quadruple-blinded, controlled trial. Seventy-four children aged 8 to 18 years with a FAPD (Irritable Bowel Syndrome or Functional Abdominal Pain-Not Otherwise Specified), diagnosed according to the Rome IV criteria, will be randomly allocated to receive either a low-FODMAP diet or a regular diet for 4 weeks. The primary outcome will be the percentage of the responders, defined as the participants who have at least 30% improvement in abdominal pain intensity on a Visual Analogue Scale (VAS) during the last week of the trial compared with baseline, that is at least equal to the Reliable Change Index (≥ 25 mm change on VAS). Other outcomes will include changes in stool consistency, abdominal pain frequency, total scores on the Gastrointestinal Symptom Rating Scale, KIDSCREEN-10 Index and World Health Organization Five Well-Being Index, child’s school attendance and parents’ work absenteeism, and BMI-for-age z-score. Compliance, tolerability of the low-FODMAP diet, and adverse events also will be evaluated. Each FAPD subtype will be assessed separately.DiscussionThere is a need for high-quality evidence regarding the dietary management of children with FAPDs. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness, if any, of a low-FODMAP diet for the management of FAPDs in the pediatric population. The findings of this RCT will assist with the development of guidelines and influence the direction of further research. Trial registration: NCT04528914

scholarly journals Nutrition of children and gastrointestinal microflora in the insult of diagnostic parameters

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Małgorzata Frajberg ◽  
Katarzyna Eufemia Przybyłowicz ◽  
Lucyna Kłe˛bukowska
Keyword(s):  
Abdominal Pain ◽  
Intestinal Microflora ◽  
Dietary Intervention ◽  
Intestinal Bacteria ◽  
Food Allergies ◽  
Functional Abdominal Pain ◽  
Double Blind ◽  
Blind Test ◽  
Before And After ◽  
Fodmap Diet

AbstractDoes dietary intervention affect the change of the intestinal microflora, causes the unsealing of the intestinal mucosa. After four weeks of dietary intervention with FODMAP diets and a diet based on NICE recommendations in children with functional abdominal pain, the intestinal microflora will change and the level of zonulin will decrease.Bacterial intestine, intestinal bacteria is a set of microorganisms, the main bacteria that form a complex ecosystem in the digestive tract. Scientific research indicates that some bacteria may contribute to the formation of certain disease entities.Children with functional abdominal pain participated in the research.The study was a randomized intervention and a double-blind test. 32 children were examined, patients of gastroenterological counseling center of the Provincial Specialist Children's Hospital in Olsztyn. Children were 4–12 years old, functional abdominal pain was diagnosed on the basis of Roman criteria, a positive decision of the gastroenterologist regarding the inclusion of the patient, conscious and voluntary consent of the child's guardian to participate in the study. Exclusion criteria include irritable bowel syndrome, abdominal migraine, diagnosed food allergies or food intolerance, the coexistence of chronic diseases or antibiotic therapy in the last 8 weeks.The dietary intervention lasted 4 weeks, meals were prepared on the basis of a menu developed by a dietician.Diagnostic tests were carried out before and after dietary intervention. One group of children with functional abdominal pain received the Fodmap diet, the second group, a diet based on NICE recommendations.The intestinal microflora, the level of zonulin in the stool were tested and the organic acids in the urine were determined by capillary gas chromatography/mass spectrometers (GC/MS).A preliminary analysis of test conditions prior to dietary intervention was found.Dysbiosis occurred in all 26 children (4 children did not perform the test). An increased number of Bacteroides spp. Was observed in the majority of children in stool tests, studies have reported that the growth of this bacterium in the intestinal microflora occurs in IBD intestinal inflammatory syndrome. Preliminary researches show that this bacterium was dominant in the examined children. In the test, an intermediate urine dysbiosis test of 24 out of 26 children was tested had at least one parameter elevated. After the dietary intervention, the diet had an effect on changing the intestinal microflora, changing the parameters of dysbiosis and the parameter of zonulin, although more research is needed on a larger population.

scholarly journals Effect of a low-FODMAP diet for the management of functional abdominal pain disorders in children: a study protocol for a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Agata Stróżyk ◽  
Andrea Horvath ◽  
Jane Muir ◽  
Hania Szajewska
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Controlled Trial ◽  
Well Being ◽  
World Health ◽  
Reliable Change Index ◽  
Functional Abdominal Pain ◽  
Regular Diet ◽  
Randomized Controlled ◽  
Fodmap Diet

Abstract Background Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared with a regular diet for the management of children with FAPDs. Methods We will perform a randomized, quadruple-blinded, controlled trial. Seventy-four children aged 8 to 18 years with a FAPD (Irritable Bowel Syndrome or Functional Abdominal Pain-Not Otherwise Specified), diagnosed according to the Rome IV criteria, will be randomly allocated to receive either a low-FODMAP diet or a regular diet for 4 weeks. The primary outcome will be the percentage of the responders, defined as the participants who have at least 30% improvement in abdominal pain intensity on a Visual Analogue Scale (VAS) during the last week of the trial compared with baseline, that is at least equal to the Reliable Change Index (≥ 25 mm change on VAS). Other outcomes will include changes in stool consistency, abdominal pain frequency, total scores on the Gastrointestinal Symptom Rating Scale, KIDSCREEN-10 Index and World Health Organization Five Well-Being Index, child’s school attendance and parents’ work absenteeism, and BMI-for-age z-score. Compliance, tolerability of the low-FODMAP diet, and adverse events also will be evaluated. Each FAPD subtype will be assessed separately. Discussion There is a need for high-quality evidence regarding the dietary management of children with FAPDs. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness, if any, of a low-FODMAP diet for the management of FAPDs in the pediatric population. The findings of this RCT will assist with the development of guidelines and influence the direction of further research. Trial registration NCT04528914 Data and protocol version identifier: 24/08/2020

Dietary Patterns: A New Therapeutic Approach for Depression?

2019 ◽  
Vol 20 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Mariana Jesus ◽  
Tânia Silva ◽  
César Cagigal ◽  
Vera Martins ◽  
Carla Silva
Keyword(s):  
Depressive Symptoms ◽  
Dietary Patterns ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Dietary Intervention ◽  
Common Mental Disorder ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Inverse Association ◽  
The Impact

Introduction: The field of nutritional psychiatry is a fast-growing one. Although initially, it focused on the effects of vitamins and micronutrients in mental health, in the last decade, its focus also extended to the dietary patterns. The possibility of a dietary cost-effective intervention in the most common mental disorder, depression, cannot be overlooked due to its potential large-scale impact. Method: A classic review of the literature was conducted, and studies published between 2010 and 2018 focusing on the impact of dietary patterns in depression and depressive symptoms were included. Results: We found 10 studies that matched our criteria. Most studies showed an inverse association between healthy dietary patterns, rich in fruits, vegetables, lean meats, nuts and whole grains, and with low intake of processed and sugary foods, and depression and depressive symptoms throughout an array of age groups, although some authors reported statistical significance only in women. While most studies were of cross-sectional design, making it difficult to infer causality, a randomized controlled trial presented similar results. Discussion: he association between dietary patterns and depression is now well-established, although the exact etiological pathways are still unknown. Dietary intervention, with the implementation of healthier dietary patterns, closer to the traditional ones, can play an important role in the prevention and adjunctive therapy of depression and depressive symptoms. Conclusion: More large-scale randomized clinical trials need to be conducted, in order to confirm the association between high-quality dietary patterns and lower risk of depression and depressive symptoms.

scholarly journals Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial

2021 ◽  
Vol 14 ◽  
pp. 175628482110217
Author(s):  
Hang Yang ◽  
Honglin Chen ◽  
Bing Hu
Keyword(s):  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Rating Scales ◽  
Rating Scale ◽  
Controlled Trial ◽  
Opioid Analgesic ◽  
Pain Syndrome ◽  
Short Term ◽  
Randomized Controlled ◽  
Term Efficacy

Background: Centrally mediated abdominal pain syndrome (CAPS) is characterized by continuous or frequently recurring abdominal pain and can result in functional loss across several life domains. The efficacy of the present management methods has not been established yet. We performed a prospective randomized controlled trial to explore the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) in patients with CAPS. Methods: We consecutively enrolled 130 patients who met the Rome IV CAPS criteria and divided them into the sufentanil + lidocaine (S + L) group and sufentanil (S) group. Patients completed the pain rating scales, including the numeric rating scale (NRS) and verbal rating scale (VRS), 60 min before colonoscopy. All the patients were initially administered sufentanil. In the S + L group, we sprayed a 5 ml solution of lidocaine on the surface of ascending, transverse, descending, and sigmoid colon during colonoscope withdrawal, while 5 ml saline was sprayed in the S group. Follow up was performed 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months after colonoscopy, to complete the pain scaling. Results: A comparison of the NRS and VRS showed that there were no significant differences between the S + L and S groups and within each group ( p > 0.05). Conclusions: Local analgesic lidocaine and opioid analgesic sufentanil showed negative efficacy during short-term observation. The opioid receptor blocker sufentanil did not worsen symptoms in patients with CAPS after colonoscopy under general anesthesia in the short term. [chictr.org.cn, Chinese Clinical Trial Identifier, ChiCTR-IOR-16008187]

scholarly journals Gluten and Functional Abdominal Pain Disorders in Children

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1491 ◽  
Author(s):  
Alejandro Llanos-Chea ◽  
Alessio Fasano
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Functional Abdominal Pain ◽  
Adults And Children ◽  
Small Intestinal ◽  
Irritable Bowel

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

scholarly journals Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Surgical Treatment ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Marked Change ◽  
Numeric Rating Scale ◽  
Observational Assessment

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

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.

Sign in / Sign up

Export Citation Format

Share Document