- Fecal Incontinence
|Efficacy of a Digital Personalized Elimination Diet for the Self-Management of Irritable Bowel Syndrome and Co-Morbid Irritable Bowel Syndrome and Inflammatory Bowel Disease
Clin Transl Gastroenterol. 2022 Nov 1.
doi: 10.14309/ctg.0000000000000545.Online ahead of print.
1Agora Health, Inc.
2Northwestern University Kellogg School of Management.
3Northwestern University Department of Psychology.
4University of Illinois at Chicago Department of Nutrition.
5Massachusetts General Hospital Division of Gastroenterology.
6Harvard Medical School.
7Digestive Healthcare of Georgia.
8Brigham and Women's Hospital Division of Gastroenterology, Hepatology and Endoscopy.
Background: A large majority of irritable bowel syndrome (IBS) and dual-diagnosis IBS and inflammatory bowel disease (IBD) patients report that symptoms originate from or are exacerbated by "trigger foods." Despite patient interest and need, there is no consensus on what diet is optimal. Popular diets have notable limitations including cost, length, implementation complexity and lack of personalization.
Intervention: This pilot study evaluated the feasibility, desirability, and impact on gastrointestinal symptoms of a digitally delivered personalized elimination diet for IBS and co-morbid IBS/IBD patients, powered by machine learning. Participants were recruited online and were provided access to a digital, personalized nutrition tool for 9 weeks (N = 37; IBS-only = 16, Crohn's Disease and IBS = 9, Ulcerative Colitis and IBS = 12).
Results: Significant symptom improvement was seen for 81% of participants at study midpoint and persisted for 70% at endpoint, measured by the relevant symptom severity score (IBS Symptom Severity Score IBS-SSS, Patient Simple Clinical Colitis Activity Index P-SCCAI or Mobile Health Index for CD, mHI-CD). Clinically significant symptom improvement was observed in 78% of participants at midpoint and 62% at endpoint. Twenty-five participants (67.6%) achieved total symptomatic resolution by end of study. Patient-reported quality of life (QoL) improved for 89% of participants. Ninety-five percent daily engagement, 95% retention, 89% adherence and 92% satisfaction with the program were reported.
Conclusions: Dietary elimination can improve symptoms and QoL in patients with IBS and co-morbid IBS/IBD. Digital technology can personalize dietary interventions and improve adherence. Randomized controlled trials are warranted.