- Fecal Incontinence
|A randomized, 6-wk trial of a low FODMAP diet in patients with inflammatory bowel disease
Bodini G1, Zanella C2, Crespi M2, Lo Pumo S2, Demarzo MG2, Savarino E2, Savarino V2, Giannini EG2. Nutrition. 2019 Jul 1;67-68:110542. doi: 10.1016/j.nut.2019.06.023. [Epub ahead of print]
1 Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy. Electronic address: email@example.com.
2 Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy.
OBJECTIVE: The aim of this study was to assess the safety and efficacy of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (LFD) in patients with inflammatory bowel disease (IBD).
METHODS: An LFD is associated with symptom improvement in patients with functional intestinal disorders, although its safety and efficacy has not been characterized in patients with IBD. Fifty-five patients with IBD in remission or with mild disease activity were randomized to a 6-wk LFD or standard diet (SD). Disease activity (Harvey-Bradshaw index [HBi], partial Mayo score), fecal calprotectin, and disease-specific quality of life (IBD-Q) were assessed at baseline and at the end of dietary intervention.
RESULTS: After the 6-wk dietary intervention, median HBi decreased in the LFD (4; IQR, 3-5 versus 3; IQR, 2-3; P?=?0.024) but not in the SD (3; IQR, 3-3 versus 3; IQR, 2-4), whereas Mayo scores were numerically decreased in the LFD group and unmodified in the SD group. Median calprotectin decreased in the LFD (76.6 mg/kg; IQR, 50-286.3 versus 50 mg/kg; IQR, 50.6-81; P?=?0.004) but not in the SD group (91 mg/kg; IQR, 50.6-143.6 versus 87 mg/kg; IQR, 50-235.6). Lastly, we observed a barely significant increase in median IBD-Q in the LFD group (166; IQR, 139-182 versus 177; IQR, 155-188; P?=?0.05) and no modification in the SD group (181; IQR, 153-197 versus 166; IQR, 153-200).
CONCLUSIONS: A short-term, LFD is safe for patients with IBD, and is associated with an amelioration of fecal inflammatory markers and quality of life even in patients with mainly quiescent disease.