Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome

• Published in: Journal of human nutrition and dietetics Vol. 24; no. 5; pp. 487 - 495
• Main Authors: Staudacher, H. M., Whelan, K., Irving, P. M., Lomer, M. C. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2011; Blackwell
• Subjects: Abdominal Pain - physiopathology; Abdominal Pain - prevention & control; Adult; Biological and medical sciences; Carbohydrates; Cross-Sectional Studies; Data processing; Diet, Carbohydrate-Restricted; Dietary Services - methods; Dietetics; Disaccharides; Disaccharides - administration & dosage; Disaccharides - metabolism; Feeding. Feeding behavior; Female; fermentable carbohydrates; Fermentation; Flatulence - physiopathology; Flatulence - prevention & control; FODMAPs; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Humans; Inventories; Irritable bowel syndrome; Irritable Bowel Syndrome - diet therapy; Male; Middle Aged; monosaccharides; Monosaccharides - administration & dosage; Monosaccharides - metabolism; Nutrient deficiency; oligosaccharides; Outpatients; Pain; Patient Satisfaction; Polymers - administration & dosage; Polymers - metabolism; polyols; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult; Human; Standard; Standards; Feeding; fermentable carbohydrates; Symptomatology; Diet; Low; Irritable bowel syndrome; FODMAPs; Digestive diseases; Intestinal disease; Carbohydrate; Comparative study
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/j.1365-277X.2011.01162.x

Background:  Emerging evidence indicates that the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may result in symptoms in some patients with irritable bowel syndrome (IBS). The present study aimed to determine whether a low FODMAP diet is effective for symptom control in patients with IBS and to compare its effects with those of standard dietary advice based on the UK National Institute for Health and Clinical Excellence (NICE) guidelines. Methods:  Consecutive patients with IBS who attended a follow‐up dietetic outpatient visit for dietary management of their symptoms were included. Questionnaires were completed for patients who received standard (n = 39) or low FODMAP dietary advice (n = 43). Data were recorded on symptom change and comparisons were made between groups. Results:  In total, more patients in the low FODMAP group reported satisfaction with their symptom response (76%) compared to the standard group (54%, P = 0.038). Composite symptom score data showed better overall symptom response in the low FODMAP group (86%) compared to the standard group (49%, P < 0.001). Significantly more patients in the low FODMAP group compared to the standard group reported improvements in bloating (low FODMAP 82% versus standard 49%, P = 0.002), abdominal pain (low FODMAP 85% versus standard 61%, P = 0.023) and flatulence (low FODMAP 87% versus standard 50%, P = 0.001). Conclusions:  A low FODMAP diet appears to be more effective than standard dietary advice for symptom control in IBS.