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Randomized Controlled Trial
. 2017 May 14;23(18):3356-3366.
doi: 10.3748/wjg.v23.i18.3356.

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Natalia Pedersen  1 , Dorit Vedel Ankersen  1 , Maria Felding  1 , Henrik Wachmann  1 , Zsuzsanna Végh  1 , Line Molzen  1 , Johan Burisch  1 , Jens Rikardt Andersen  1 , Pia Munkholm  1
Affiliations
Randomized Controlled Trial

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Natalia Pedersen et al. World J Gastroenterol. .

Abstract

Aim: To investigate the effect of a low-FODMAP diet on irritable bowel syndrome (IBS)-like symptoms in patients with inflammatory bowel disease (IBD).

Methods: This was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms (Rome III) randomly assigned to a Low-FODMAP diet (LFD) or a normal diet (ND) for 6 wk between June 2012 and December 2013. Patients completed the IBS symptom severity system (IBS-SSS) and short IBD quality of life questionnaire (SIBDQ) at weeks 0 and 6. The primary end-point was response rates (at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of life.

Results: Eighty-nine patients, 67 (75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis (37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group (n = 30, 81%) than in the ND group (n = 19, 46%); (OR = 5.30; 95%CI: 1.81-15.55, P < 0.01). At week 6, the LFD group showed a significantly lower median IBS-SSS (median 115; inter-quartile range [IQR] 33-169) than ND group (median 170, IQR 91-288), P = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ (median 60, IQR 51-65) than the ND group (median 50, IQR 39-60), P < 0.01.

Conclusion: In a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.

Keywords: Inflammatory bowel disease; Irritable bowel syndrome; Low-FODMAP diet; Web-based management.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Enrollment and progress of patients in the study. IBD: Inflammatory bowel disease; ND: Normal diet; LFD: Low-FODMAP diet.
Figure 2
Figure 2
Logistic regression analysis of the total irritable bowel syndrome-severity score system response and its subscores for the normal diet and low FODMAP diet groups at 6-wk. IBS: Irritable bowel syndrome; SSS: Symptom severity score; ND: Normal diet; LFD: Low-FODMAP diet; N: Number; L95CI: Lower 95% confidence interval; U95CI: Upper 95% confidence interval.
Figure 3
Figure 3
Box plot of irritable bowel syndrome-severity score system crude data in means ± SD, medians (range) for the normal diet and low FODMAP diet groups at 0 vs 6-wk. IBS: Irritable bowel syndrome; SSS: Symptom severity score; ND: Normal diet; LFD: Low-FODMAP diet.
Figure 4
Figure 4
Box plot of short inflammatory bowel disease questionnaire crude data in means ± SD, medians (range) for the normal diet and low FODMAP groups at 0 vs 6-wk. SIBDQ: Short inflammatory bowel disease quality of life; ND: Normal diet; LFD: Low-FODMAP diet.
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