A Low-FODMAP Diet for Irritable Bowel Syndrome: Some Answers to the Doubts from a Long-Term Follow-Up

Nutrients. 2020 Aug 7;12(8):E2360. doi: 10.3390/nu12082360.

Massimo Bellini 1, Sara Tonarelli 1, Federico Barracca 1, Riccardo Morganti 2, Andrea Pancetti 1, Lorenzo Bertani 1, Nicola de Bortoli 1, Francesco Costa 1, Marta Mosca 3, Santino Marchi 1, Alessandra Rossi 3


Author information

  • 1Gastrointestinal Unit-Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy.
  • 2SOD Clinical Trial Statistical Support, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy.
  • 3Clinical and Experimental Medicine-Rheumatology Unit, University of Pisa, 56100 Pisa, Italy.


A low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet (LFD) is a possible therapy for irritable bowel syndrome (IBS). This study investigates the short- and long-term efficacy and nutritional adequacy of an LFD and the patients' long-term acceptability. Patients' adherence and ability to perceive the "trigger" foods were also evaluated. Seventy-three IBS patients were given an LFD (T0) and after 2 months (T1), 68 started the reintroduction phase. At the end of this period (T2), 59 were advised to go on an Adapted Low-FODMAP Diet (AdLFD) and 41 were evaluated again after a 6-24 month follow-up (T3). At each time, questionnaires and Biolectrical Impedance Vector Analysis (BIVA) were performed. The LFD was effective in controlling digestive symptoms both in the short- and long-term, and in improving quality of life, anxiety and depression, even if some problems regarding acceptability were reported and adherence decreased in the long term. The LFD improved the food-related quality of life without affecting nutritional adequacy. When data collected at T0 were compared with those collected at T2, the perception of trigger foods was quite different. Even if some problems of acceptability and adherence are reported, an LFD is nutritionally adequate and effective in improving IBS symptoms also in the long term.

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