Evaluation of the effects of the FODMAP diet and probiotics on irritable bowel syndrome (IBS) symptoms, quality of life and depression in women with IBS

• Published in: Journal of human nutrition and dietetics Vol. 37; no. 1; pp. 5 - 17
• Main Authors: Ustaoğlu, Tuba, Tek, Nilüfer Acar, Yıldırım, Abdullah Emre
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.02.2024
• Subjects: Adult; Anxiety; depression; Depression - etiology; Diet; diet therapy; Dietary supplements; dietetics; Disaccharides; Female; females; Fermentation; FODMAP Diet; Food intake; hospitals; Humans; IBS symptom severity; Intestine; Irritable Bowel Syndrome; Lactobacillus rhamnosus; Lactose; Mannitol; Mental depression; Mental health; Microbiota; Middle Aged; Monosaccharides; Nutrient deficiency; Nutrients; Nutrition research; Nutrition therapy; Nutritional status; Oligosaccharides; people; Polyols; Prebiotics; probiotic; Probiotics; Quality of Life; Sorbitol; Statistical analysis; Treatment Outcome; Womens health; Young Adult; probiotic; IBS symptom severity; depression; quality of life; irritable bowel syndrome; FODMAP diet
• ISSN: 0952-3871; 1365-277X; 1365-277X
• DOI: 10.1111/jhn.13194

Background The present study aimed to evaluate the effects of fermented oligosaccharide, disaccharide, monosaccharide and polyols (FODMAP) diet therapy and probiotics on irritable bowel syndrome (IBS) symptoms, quality of life and depression in women diagnosed with IBS. Methods For the study, 52 female IBS patients between the ages of 20 and 55 were enrolled. Individuals were monitored for 6 weeks in two groups. A low‐FODMAP diet was given to the first group and a low‐FODMAP diet plus a probiotic supplement was given to the second group (Lactobacillus rhamnosus). Three‐day food intake records were kept at the start of the study and continued up to its conclusion, with a weekly check‐in in between. At the start and end of the trial, participants completed the Hospital Anxiety and Depression Scale, IBS Quality of Life Scale (IBS‐QOL) and IBS Symptom Severity Score (IBS‐SSS). The Bristol Stool Scale was also used by the subjects to record their daily stool densities. Results At the end of the study, it was determined that the daily intake of FODMAP (lactose [g] + oligosaccharides [g] + mannitol [g] + sorbitol [g]) decreased significantly in both groups (p < 0.05). At the end of the study, it was determined that the IBS‐SSS, anxiety and depression scores of the individuals in both groups decreased significantly and their IBS‐QOL scores increased significantly (p < 0.05). However, the difference between these values between the groups was not statistically significant (p > 0.05). Conclusions A low‐FODMAP diet has been demonstrated to benefit people by lessening the severity of their IBS symptoms and enhancing their quality of life. No evidence was found, however, to indicate that the FODMAP diet would be more beneficial on these metrics if additional probiotics were used. It should be emphasised that the reaction of probiotic strains may vary depending on the IBS subtype. When symptoms worsen, it may be advised to follow a low‐fermented oligosaccharide, disaccharide, monosaccharide and polyols (FODMAP) diet for 2–8 weeks before gradually reintroducing the person to their regular eating routine. To prevent long‐term nutrient deficits, it is important to monitor energy and nutrient intakes during the diet under the direction of a nutritionist. Highlights A low fermented oligosaccharide, disaccharide, monosaccharide and polyols (FODMAP) diet may be recommended to apply for 2–8 weeks when symptoms become severe, gradually transitioning the individual to the normal nutrition process when symptoms subside. It is necessary to follow up the energy and nutrient intakes according to individual characteristics during the diet under the guidance of a dietitian to prevent nutrient deficiencies in the long term. Patients should be given dietary advice on choosing high‐fibre, low‐FODMAP‐sourced fruits, vegetables and grains to balance their daily fibre intake. FODMAP restriction reduces the intake of prebiotics, which affects the gastrointestinal microbiota.