Implementation of a low FODMAP diet for functional abdominal pain

Castro, María Luisa Baranguán; Arnal, Ignacio Ros; Romero, Ruth García; Martínez, Gerardo Rodríguez; Sainz, Eduardo

doi:10.1016/j.anpede.2018.02.014

Cited by 13 publications

(30 citation statements)

References 34 publications

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“…The NICE group reported a significant reduction of symptoms throughout consecutive weeks of the diet. In contrast to previous studies which did not have a control group on a normal diet (13,14), no significant differences were observed in the abdominal pain intensity and frequency between the 2 groups and no significant change was seen in stool frequency.…”

Section: Indications and Contraindications In Pediatric Gi Conditionscontrasting

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Excluding oligo-, di-, monosaccharides and polyols (FODMAPs) from the diet is increasingly being used to treat children with gastrointestinal complaints. The aim of this position paper is to review the available evidence on the safety and efficacy of its use in children and provide expert guidance regarding practical aspects in case its use is considered. Members of the Gastroenterology Committee, the Nutrition Committee and the Allied Health Professionals Committee of the European Society for Pediatric Gastroenterology Hepatology and Nutrition contributed to this position paper. Clinical questions regarding initiation, introduction, duration, weaning, monitoring, professional guidance, safety and risks of the diet are addressed. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. The systematic literature search revealed that the low-FODMAP diet has not been comprehensively studied in children. Indications and contraindications of the use of the diet in different pediatric gastroenterological conditions are discussed and practical recommendations are formulated. There is scarce evidence to support the use of a low-FODMAP diet in children with Irritable Bowel Syndrome and no evidence to recommend its use in other gastrointestinal diseases and complaints in children. Awareness of how and when to use the diet is crucial, as a restrictive diet may impact nutritional adequacy and/or promote distorted eating in vulnerable subjects. The present article provides practical safety tips to be applied when the low-FODMAP diet is considered in children.

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Section: Indications and Contraindications In Pediatric Gi Conditionscontrasting

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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show abstract

“…In our study, no significant change was observed in stool consistency, and the three subclasses of IBS improved equally. These results are consistent with those of other pediatric studies [ 21 23 ], while, in a meta-analysis of the adult population, IBS symptom improvement was also consistent between subgroups stratified according to IBS subtypes. However, three studies regarding stool habit changes in patients with IBS-D showed a significant decrease in stool frequency and a significant improvement in stool consistency in the low FODMAP diet group compared to the control group [ 17 ].…”

Section: Discussionsupporting

confidence: 92%

“…This cohort study was conducted [ 23 ] in 2019. It was started in 22 patients with FAP and dyspepsia.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients

Gendy

Ragab

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. Methods This clinical trial included 50 patients aged 3–18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. Results After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. Conclusion A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

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“…Efficacy of the low FODMAP diet in reducing gastrointestinal symptoms has been demonstrated in adults with FAPDs (mainly IBS) [9, 12, 16]. However, only 3 prospective studies of low FODMAP diet have been conducted in children with FAPDs [28-30]. Two of these studies, including 1 randomized controlled trial, focused on children with IBS and reported a reduction in the frequency of abdominal pain, although the improvement appeared to be more modest than that previously reported in adults [28, 29].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…A third study explored the associations between low FODMAP diet and gastrointestinal symptoms in children with various FAPDs (FAP, IBS, or FD) analyzed as 1 group. The authors reported symptom improvement after 2 weeks of the dietary intervention [30]. However, this was an open-label study without a control group, and the dietary intervention was based on the list of “allowed” and “not allowed” products.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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

2020

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Introduction: 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). Objective: 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. Methods: 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. Results: 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 (p < 0.01) and improvement in stool consistency (93% reporting normal stool, p < 0.05). Conclusions: The results of this pilot study suggest that the low FODMAP diet is not effective in the reduction of symptoms in children with FAP.

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Implementation of a low FODMAP diet for functional abdominal pain

Cited by 13 publications

References 34 publications

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients

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

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