Abstract

Diet low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome as Well as Traditional Dietary Advice: A Randomized Controlled Trial

Böhn L1, Störsrud S1, Liljebo T2, Collin L3, Lindfors P4, Törnblom H1, Simrén M5. Gastroenterology. 2015 Aug 5. pii: S0016-5085(15)01086-0. doi: 10.1053/j.gastro.2015.07.054. [Epub ahead of print]
 
     
Author information

1Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 2Department of Nutrition, Karolinska University Hospital, Stockholm, Sweden. 3Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden. 4Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden. 5Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: magnus.simren@medicine.gu.se.

Abstract

BACKGROUND & AIMS: A diet with reduced content of fermentable short chain carbohydrates (fermentable oligo-, di-, monosaccharides and polyols, FODMAPs) has been reported to be effective in the treatment of patients with irritable bowel syndrome (IBS). However, there is no evidence for its superiority to traditional dietary advice for these patients. We compared the effects a diet low in FODMAPs with traditional dietary advice in a randomized, controlled trial of patients with IBS.

METHODS: We performed a multi-center, parallel, single-blind study of 75 patients who met the Rome III criteria for IBS, enrolled at gastroenterology outpatient clinics in Sweden. Subjects were randomly assigned to groups that ate specific diets for 4 weeks: a diet low in FODMAPs (n=38) or a diet frequently recommended for patients with IBS (a regular meal pattern; avoidance of large meals; and reduced intake of fat, insoluble fibers, caffeine and gas-producing foods such as beans, cabbage, and onions), with greater emphasis on how and when to eat rather than on what foods to ingest (n=37). Symptom severity was assessed using the IBS severity scoring system, and patients completed a 4 day food diary before and at the end of the intervention.

RESULTS: A total of 67 patients completed the dietary intervention (33 completed the diet low in FODMAPs, 34 completed the traditional IBS diet). The severity of IBS symptoms was reduced in both groups during the intervention (P<.0001 in both groups, before vs at the end of the 4 week diet), without a significant difference between the groups (P=.62). At the end of the 4 week diet period, 19 patients (50%) in the low FODMAP group had reductions in IBS severity scores ≥50, compared with baseline, vs 17 patients (46%) in the traditional IBS diet group (P=.72). Food diaries demonstrated good adherence to the dietary advice.

CONCLUSIONS: A diet low in FODMAPs reduces symptoms of IBS symptoms as well as traditional IBS dietary advice. Combining elements from these 2 strategies might further reduce symptoms of IBS.

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