scholarly journals Adherence and Effects Derived from FODMAP Diet on Irritable Bowel Syndrome: A Real Life Evaluation of a Large Follow-Up Observation

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 928 ◽  
Author(s):  
Antonietta Gerarda Gravina ◽  
Marcello Dallio ◽  
Mario Romeo ◽  
Antonietta Di Somma ◽  
Gaetano Cotticelli ◽  
...  

Introduction: Irritable bowel syndrome represents one of the most difficult gastroenterological diseases to treat, that usually induces the patients to follow different drug therapies, often not useful in symptom control. In this scenario low FODMAP diet could have positive effects in patients with irritable bowel syndrome, even because this type of diet regimen is characterized by a low gluten amount due to the exclusion of cereals. Methods: We enrolled 120 patients with irritable bowel syndrome, according to the Rome IV criteria, who were referred to Hepatogastroenterology Division of the University of Campania L. Vanvitelli from June to December 2018. They underwent a low FODMAP diet for six weeks, followed by a gradual weekly reintroduction of every category of food for three months. The patients had a follow-up evaluation for six months after the end of food reintroduction period. We measured abdominal pain with subjective numerical scale from 0 to 10. We evaluated other gastrointestinal symptoms with a questionnaire about symptoms of lower digestive tract, evaluating their frequency and intensity. We also evaluated the impact of irritable bowel syndrome on daily life with neurological bowel dysfunction score. Results: We obtained a good patient-adherence to diet and a statistically significant decrease of abdominal pain, bloating, flatulence, diarrhea, constipation, and neurological bowel dysfunction score (p < 0.001) at the end of the diet. These results remained constant in the follow-up period. Conclusions: We recommend the use of a low FODMAP diet regimen in patients with irritable bowel syndrome in order to control the symptoms and improve the quality of life.

Gut ◽  
2021 ◽  
pp. gutjnl-2021-325214
Author(s):  
Christopher J. Black ◽  
Heidi M. Staudacher ◽  
Alexander C. Ford

ObjectiveA diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle and dietary advice fails. However, although the impact of a low FODMAP diet on individual IBS symptoms has been examined in some randomised controlled trials (RCTs), there has been no recent systematic assessment, and individual trials have studied numerous alternative or control interventions, meaning the best comparator is unclear. We performed a network meta-analysis addressing these uncertainties.DesignWe searched the medical literature through to 2 April 2021 to identify RCTs of a low FODMAP diet in IBS. Efficacy was judged using dichotomous assessment of improvement in global IBS symptoms or improvement in individual IBS symptoms, including abdominal pain, abdominal bloating or distension, and bowel habit. Data were pooled using a random effects model, with efficacy reported as pooled relative risks (RRs) with 95% CIs, and interventions ranked according to their P-score.ResultsWe identified 13 eligible RCTs (944 patients). Based on failure to achieve an improvement in global IBS symptoms, a low FODMAP diet ranked first vs habitual diet (RR of symptoms not improving=0.67; 95% CI 0.48 to 0.91, P-score=0.99), and was superior to all other interventions. Low FODMAP diet ranked first for abdominal pain severity, abdominal bloating or distension severity and bowel habit, although for the latter it was not superior to any other intervention. A low FODMAP diet was superior to British Dietetic Association (BDA)/National Institute for Health and Care Excellence (NICE) dietary advice for abdominal bloating or distension (RR=0.72; 95% CI 0.55 to 0.94). BDA/NICE dietary advice was not superior to any other intervention in any analysis.ConclusionIn a network analysis, low FODMAP diet ranked first for all endpoints studied. However, most trials were based in secondary or tertiary care and did not study effects of FODMAP reintroduction and personalisation on symptoms.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 780 ◽  
Author(s):  
Robin Spiller

Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future.


Author(s):  
Stephanie K. Gaskell ◽  
Ricardo J.S. Costa

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.


2020 ◽  
Vol 120 (4) ◽  
pp. 535-547 ◽  
Author(s):  
Heidi M. Staudacher ◽  
Frances S.E. Ralph ◽  
Peter M. Irving ◽  
Kevin Whelan ◽  
Miranda C.E. Lomer

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2360 ◽  
Author(s):  
Massimo Bellini ◽  
Sara Tonarelli ◽  
Federico Barracca ◽  
Riccardo Morganti ◽  
Andrea Pancetti ◽  
...  

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.


2012 ◽  
Vol 107 (4) ◽  
pp. 627-631 ◽  
Author(s):  
Arine M Vlieger ◽  
Juliette M T M Rutten ◽  
Anita M A P Govers ◽  
Carla Frankenhuis ◽  
Marc A Benninga

2012 ◽  
Vol 142 (5) ◽  
pp. S-134 ◽  
Author(s):  
Arine M. Vlieger ◽  
Juliette M. Rutten ◽  
Anita M. Govers ◽  
Carla Frankenhuis ◽  
Marc A. Benninga

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yu-xia Ma ◽  
Xiao Liu ◽  
Cun-zhi Liu ◽  
Lin-peng Wang ◽  
Gang Guo ◽  
...  

Objective. To explore the efficacy of Herb-partitioned moxibustion in treating IBS-D patients.Method. 210 IBS-D patients were randomly assigned on a3:3:2basis to group HM, group FM, or group PB for 4-week treatment. The change of GSRS total score at weeks 4 and 8, the changes of GSRS specific scores, and adverse events were evaluated.Results. Patients in group HM and group FM had lower GSRS total score at week 4 (1.98±0.303,2.93±0.302versus3.73±0.449) and at week 8 (2.75±0.306,3.56±0.329versus4.39±2.48) as compared with patients’ score in group PB. However, there was no significant difference of GSRS total score between group HM and group FM. The effect of HM was significantly greater than that of orally taking PB in ameliorating the symptoms of rugitus (0.38 versus 0.59,P<0.05), abdominal pain (0.28 versus 0.57,P<0.01), abdominal distension (0.4 versus 0.7,P<0.01), and increased passage of stools (0.06 versus 0.25,P<0.01) at the end of treatment period. In the follow-up period, patients’ therapeutic effect in group HM remained greater than that in group FM (in abdominal pain, abdominal distension, and increased passage of stools) and that in group PB (in loose stools).Conclusions. HM appears to be a promising, efficacious, and well-tolerated treatment for patients with IBS-D.


2004 ◽  
Vol 18 (3) ◽  
pp. 181-182
Author(s):  
John K Marshall

Most recommendations for managing irritable bowel syndrome emphasize the positive roles of patient education and reassurance (1), but the impact and value of these approaches are difficult to assess. Therefore, a recent paper by Ilnyckyj et al (2) is both relevant and reassuring. This well designed study used Manitoba Health administrative databases to track health resource utilization, before and after a standardized gastroenterology consultation, by a consecutive cohort of patients with Rome I irritable bowel syndrome (IBS) attending an academic tertiary care clinic. Subjects also completed standardized survey instruments at the time of the consultation, one year and two years later to assess physical morbidity, psychological function and pain severity. During the two years of follow-up, the authors observed a reduction from baseline in the use of health resources for gastrointestinal diagnoses, but no change in consumption of resources for other indications. While pain was improved at follow-up, other measures of physical and psychological health were unchanged.


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