Abstract | 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. METHODS:
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. RESULTS: 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. CONCLUSIONS: 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.
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Authors | R H de Roest, B R Dobbs, B A Chapman, B Batman, L A O'Brien, J A Leeper, C R Hebblethwaite, R B Gearry |
Journal | International journal of clinical practice
(Int J Clin Pract)
Vol. 67
Issue 9
Pg. 895-903
(Sep 2013)
ISSN: 1742-1241 [Electronic] India |
PMID | 23701141
(Publication Type: Evaluation Study, Journal Article, Observational Study)
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Copyright | © 2013 John Wiley & Sons Ltd. |
Chemical References |
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Topics |
- Abdominal Pain
(diet therapy, etiology)
- Breath Tests
- Diarrhea
(diet therapy, etiology)
- Female
- Flatulence
(diet therapy, etiology)
- Fructose
(pharmacokinetics)
- Fructose Intolerance
(complications, diet therapy)
- Humans
- Irritable Bowel Syndrome
(diet therapy, etiology)
- Lactose
(pharmacokinetics)
- Lactose Intolerance
(complications, diet therapy)
- Malabsorption Syndromes
(complications, diet therapy)
- Male
- Middle Aged
- Patient Compliance
- Patient Satisfaction
- Prospective Studies
- Treatment Outcome
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