Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome

Abstract

Abstract. Diet is important in triggering the symptoms of irritable bowel syndrome (IBS). This study investigated the impact of dietary guidance on the symptoms, quality of life and habitual diet of patients with IBS. Forty-six patients who included. Of these patients, 17 completed the entire study. Each patient attended three sessions (~45 min in duration) and received individual guidance on their dietary management. The patients were asked to complete the following questionnaires prior to receiving the dietary guidance, and at least 3 months subsequently: The Birmingham IBS symptom score questionnaire, the IBS Quality of Life (IBS-QOL) questionnaire, the Short-Form Nepean and Dyspepsia Index (SF-NDI) and the MoBa Food Frequency Questionnaire (MoBa FFQ). The time at which patients completed the questionnaires following dietary guidance ranged from 3-9 months (median, 4 months). The total IBS symptom scores were reduced once the patients had received dietary guidance (P=0.001). The total score for the quality of life, as assessed by the IBS-QOL guidance sessions (P=0.003 and P=0.002, respectively). There were no statistical differences in the intake of calories, IBS following dietary guidance. There were increases in the consumption of dairy products, -carotene, retinol equivalents, 12 and calcium, although only the increase in vitamin B 12 and vegetables that were rich in highly fermentable short-chain carbohydrates, disaccharides, monosaccharides and polyols, as guidance sessions, administered by a nurse, reduced the symptoms and improved the quality of life of patients with IBS, and resulted in an adequate intake of vitamins and minerals. Individual dietary guidance is a cost-effective option for the management of IBS. IntroductionIrritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by a combination of symptoms that have a considerable impact on the patient's quality of life. These symptoms include abdominal pain or discomfort and altered bowel habits (1,2). IBS is more common in females than in males, and is diagnosed more frequently in patients under the age of 50 (1). The prevalence of IBS has been calculated to range from 5-15% of the population worldwide, as determined by diagnostic criteria, such as the Rome criteria (1-14).Approximately two-thirds of patients with IBS consider their symptoms to be related to their diet (15) and therefore restrict their intake of certain dietary agents that they perceive to be provocative. The most commonly reported triggers are carbohydrates and fatty foods, milk and dairy products, wheat products, caffeine, hot spices, certain meats, cabbage, onions, peas, beans and fried and smoked foods (16)(17)(18)(19). Despite these reported effects, numerous studies have demonstrated that dietary composition does not markedly differ between patients with IBS and controls (15-21), although patients with IBS appear to have a low intake of calcium, potassium, magnesium, vitamin A, vitamin B 12 In a previous study by our group, dietary guidance admini...

Restriction of FODMAP in the management of bloating in irritable bowel syndrome

“…(24,33,38) Meta-analysis data (37) reported a significant improvement in the IBS-QOL score (OR 1.84, 95% CI 1.12-3.03; I 2 = 0.00, p = 0.39).…”

“…Previous studies have established the importance of offering education, information and general support in the management of IBS. Given individually or to a group, (38,45) advice and guidance on FODMAP restriction is a cost-effective therapy in the management of IBS-related bloating. Nevertheless, the ideal mode and medium for patient education remain debatable.…”

“…Nevertheless, the ideal mode and medium for patient education remain debatable. While most trials involved a FODMAPcertified dietitian, a nurse-led dietary guidance consisting three 45-minute sessions (38) resulted in a favourable symptom response (41.47 ± 1.62 to 35.71 ± 1.12; p = 0.001); hence, written gas and pain) was seen more in IBS patients on the fructose-fructan mix (79%) compared to patients on fructan (77%), fructose (70%) and glucose (14%) (p < 0.001). (28) …”

The Role of Low FODMAP Diet in the Management of Irritable Bowel Syndrome

“…Several other studies have since reported on the mechanisms underlying the impact of FODMAPs on intestinal function, and the therapeutic role that a low FODMAP diet may play for patients with IBS-related gastrointestinal symptoms [18,[31][32][33][34][35][36][37][38][39][40].…”

“…Malabsorption of fructose or lactose and small intestinal bacterial overgrowth were combined in 75.6%, 37.8%, and 13.3% of patients, respectively; fructose malabsorption was significantly associated with symptom reduction subsequent to following a low FODMAP diet [37] . Other prospective studies have demonstrated the beneficial effects of FODMAP-related dietary guidance [38] and intervention [39] on overall IBS symptoms and quality of life. A nonrandomized controlled trial conducted in England compared IBS patients who followed a low FODMAP diet with those who received standard dietary advice [40] .…”