Follow-up of patients with functional bowel symptoms treated with a low FODMAP diet

Maagaard, Louise; Ankersen, Dorit Vedel; Végh, Zsuzsanna; Burisch, Johan; Jensen, Lisbeth; Pedersen, Natalia; Munkholm, Pia

doi:10.3748/wjg.v22.i15.4009

Cited by 111 publications

(151 citation statements)

References 31 publications

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“…In the second RCT, although there was no difference in proportion of patients achieving the adequate relief endpoint, there were a greater number of pain responders in the low FODMAP group (51%) compared with standard advice (23%, p=0.008), as well as a greater magnitude of response of multiple individual symptoms (abdominal pain, bloating, stool consistency frequency and urgency) 70. These data on individual symptom response are consistent with previous findings of a non-randomised comparative trial that reported a significant difference in the numbers responding to low FODMAP dietary advice (76%) compared with standard National institute for Health and Care Excellence (NICE) guideline dietary advice (54%) 63. One recent trial also compared the low FODMAP diet with hypnotherapy in IBS 71.…”

Section: The Low Fodmap Dietsupporting

confidence: 87%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

272

236

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There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet) is now increasingly used in the clinical setting. Initial research evaluating the efficacy of the low FODMAP diet was limited by retrospective study design and lack of comparator groups, but more recently well-designed clinical trials have been published. There are currently at least 10 randomised controlled trials or randomised comparative trials showing the low FODMAP diet leads to clinical response in 50%-80% of patients with IBS, in particular with improvements in bloating, flatulence, diarrhoea and global symptoms. However, in conjunction with the beneficial clinical impact, recent studies have also demonstrated that the low FODMAP diet leads to profound changes in the microbiota and metabolome, the duration and clinical relevance of which are as yet unknown. This review aims to present recent advances in the understanding of the mechanisms by which the low FODMAP diet impacts on symptoms in IBS, recent evidence for its efficacy, current findings regarding the consequences of the diet on the microbiome and recommendations for areas for future research.

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Section: The Low Fodmap Dietsupporting

confidence: 87%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

272

236

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“…Accordingly, it was found that three‐quarters of the patients were strikingly satisfied. Our finding was also evidenced by studies which found that patients were fairly satisfied, even those who underwent group education and not one‐on‐one sessions 18, 21…”

Section: Discussionsupporting

confidence: 77%

Low FODMAP diet in Egyptian patients with Crohn's disease in remission phase with functional gastrointestinal symptoms

et al. 2018

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Background and AimDespite being in remission, functional gastrointestinal disease (FGID) in Crohn's disease (CD) patients can reduce their quality of life. The Egyptian daily diet contains a high amount of FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols). As the low FODMAP diet has been proven to be effective in irritable bowel syndrome worldwide, it was reasonable to take a step further and begin to study the effect of low FODMAP in Egyptian CD patients with FGID. The outcomes were assessed in terms of improvement in symptoms and hence the quality of life, and the factors that led to this improvement were also recorded.MethodsIn total, 100 CD patients with FGID in the remission stage who were already on a low‐fiber diet (± lactose‐free diet) were selected to follow the low FODMAP diet. A structured interview was performed after 3 months with a number of scored‐scale questionnaires comparing symptoms before and after the diet and the impact on quality of life. Evaluation of the adherence, satisfaction, palatability, and affordability of the diet was performed. Different demographic data were also evaluated in correspondence with improvements in the quality of life.ResultsThe mean score of FGID improvement was 38.45 ± 21.56%. The quality of life was significantly improved; 90% of female patients versus 49.4% males had a better quality of life. The households (not working) as well as those with morning jobs (6 hours) reported an increase in quality of life. Although the Egyptian low FODMAP diet was expensive (in terms of gluten‐free wheat), 67% were adherent to it (18.16 ± 6.85).ConclusionAs a first step in Egypt, the low FODMAP diet was effective in improving the quality of life of CD patients with FGID.

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“…Recent studies with IBD patients with gastrointestinal symptoms showed a significant symptom relief under low FODMAP diet [39,41]. The evaluation of the daily sugar consumption revealed higher amounts in our IBD patients compared to healthy controls providing a potential explanation for gastrointestinal symptoms in some of these patients.…”

Section: Food Group Hc Total Ibd Ibd (Intake In [G/d]) CD Ucmentioning

confidence: 55%

“…According to the BMI-classification of the World Health Organization (WHO), a BMI less than 18.5 kg/m² was considered as underweight, between 18.5 kg/m² to 25.0 kg/m² as normal weight, between 25.0 kg/ m² to 30.0 kg/m² as overweight (pre-obese) and over 30.0 kg/m² as obese [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45].…”

Section: Nutritional Statusmentioning

confidence: 99%

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

Schink¹,

Mirsch²,

Dieterich³

et al. 2017

J Nutr Food Sci

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Patients with inflammatory bowel diseases (IBD) are often affected by nutrient deficiencies. Besides a limited nutrient intake by disease-related side effects and malabsorption, the influence of diets and dietary changes is much discussed. However, data about food patterns are mostly based on subjective declarations. Therefore, this study aimed to achieve a detailed and objective analysis of nutrient intake and individual food habits in IBD, a prerequisite for an appropriate nutritional intervention in risk patients. One hundred IBD patients (n=70 Crohn's disease (CD), n=30 ulcerative colitis (UC)) and 30 healthy controls (HC) were included in the study. All participants filled in a disease-related and food frequency questionnaire. Fifteen healthy controls and 71 IBD patients additionally completed a questionnaire for self-imposed food restrictions. Most IBD patients and healthy controls showed a normal body mass index. However, within the IBD group, UC patients were more often overweight than CD patients (p=0.007). Food restrictions were common in all participants, but significantly more IBD patients restricted their consumption of fast food (p=0.037), fruits and vegetables (p=0.019). Especially CD patients with acute relapse consumed less fruits and vegetables (p=0.035). Contrary to subjective assessment, an objective survey of dietary intake revealed a significantly higher sugar intake of IBD patients compared to healthy controls (p<0.001) with an increased ingestion of sugar/confectionery (p=0.041), soft/isotonic drinks (p<0.001) and fruit/vegetable juices (p=0.022). Additionally, IBD patients ingested higher amounts of salt than healthy controls (p=0.005). Both groups showed an insufficient ingestion of folate, vitamin D and pantothenic acid.In conclusion, self-managed food restrictions appear to be common in IBD patients. The huge discrepancy between the subjective view of dietary habits and objective evaluation of nutrient intake indicates that nutrient assessment should be based on objective tools. A repetitive professional nutritional counseling is recommended to prevent and treat nutritional deficiencies.

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Follow-up of patients with functional bowel symptoms treated with a low FODMAP diet

Abstract: These data suggest that a diet low in FODMAPs is an efficacious treatment solution in the management of functional bowel symptoms for IBS and IBD patients.

Cited by 111 publications

References 31 publications

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Low FODMAP diet in Egyptian patients with Crohn's disease in remission phase with functional gastrointestinal symptoms

Dietary Habits and Nutrient Intake in Patients with Inflammatory Bowel Disease

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