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

Published on Aug 7, 2020in Nutrients4.546
· DOI :10.3390/NU12082360
Massimo Bellini35
Estimated H-index: 35
(UniPi: University of Pisa),
Sara Tonarelli3
Estimated H-index: 3
(UniPi: University of Pisa)
+ 8 AuthorsAlessandra Rossi23
Estimated H-index: 23
(UniPi: University of Pisa)
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.
#2Marcello DallioH-Index: 18
Last. Alessandro FedericoH-Index: 36
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Introduction: Irritable bowel syndrome represents one of the most difficult gastroenterological diseases to treat, that usually induces the patients to follow different drug therapies, often not useful in symptom control. In this scenario low FODMAP diet could have positive effects in patients with irritable bowel syndrome, even because this type of diet regimen is characterized by a low gluten amount due to the exclusion of cereals. Methods: We enrolled 120 patients with irritable bowel syndrom...
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#1Guido Basilisco (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 25
BACKGROUND: Patients with chronic constipation (CC) or with irritable bowel syndrome with constipation are often dissatisfied about their medical therapy, but their condition remains poorly defined. AIM: To evaluate the patients' satisfaction rates and which factors predict favourable outcomes through the aggregate analysis of N-of-1 trials. METHODS: Eighty-one outpatients with CC or with irritable bowel syndrome with constipation underwent N-of-1 trials with at least a one-month cycle of effect...
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#1Massimo Bellini (UniPi: University of Pisa)H-Index: 35
#2Sara Tonarelli (UniPi: University of Pisa)H-Index: 3
Last. Alessandra Rossi (UniPi: University of Pisa)H-Index: 23
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Food is often considered to be a precipitating factor of irritable bowel syndrome (IBS) symptoms. In recent years, there has been a growing interest in FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols), which can be found in many common foods. A low FODMAP diet (LFD) is increasingly suggested for IBS treatment. However, long-term, large, randomized controlled studies are still lacking, and certainties and doubts regarding LFDs have grown, often in a disorderly and confused manner....
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#1Massimo Bellini (UniPi: University of Pisa)H-Index: 35
#2Alessandra Rossi (UniPi: University of Pisa)H-Index: 23
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#1Joanna C. Dionne (McMaster University)H-Index: 9
#2Alexander C. Ford (University of Leeds)H-Index: 86
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Dietary triggers such as gluten and highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP)-containing foods have been associated with worsening irritable bowel syndrome (IBS) symptoms. However, the true impact of dietary restriction on IBS symptoms has remained unclear. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the efficacy of exclusion diets (we focused on low FODMAP and gluten-free diets (GFD)) i...
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#1Cesare Cremon (UNIBO: University of Bologna)H-Index: 31
#2Simone Guglielmetti (University of Milan)H-Index: 34
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BackgroundEvidence suggests a role of intestinal microbiota-host interactions in the pathophysiology and symptoms of irritable bowel syndrome (IBS).ObjectiveThe objective of this article is to assess the effects of Lactobacillus paracasei CNCM I-1572 on clinical and gut microbiota-related factors in IBS.MethodsWe conducted a multicenter, randomized, double-blind, cross-over, 18-week, placebo-controlled, pilot trial assessing the effect of Lactobacillus paracasei CNCM I-1572 on symptoms, gut micr...
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#1Majella O'Keeffe ('KCL': King's College London)H-Index: 12
#2Christian Jansen ('KCL': King's College London)H-Index: 10
Last. M Lomer ('KCL': King's College London)H-Index: 7
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Background The low-FODMAP diet is a frequently used treatment for irritable bowel syndrome (IBS). Most research has focused on short-term FODMAP restriction; however, guidelines recommend that high-FODMAP foods are reintroduced to individual tolerance. This study aimed to assess the long-term effectiveness of the low-FODMAP diet following FODMAP reintroduction in IBS patients. Methods Patients with IBS were prospectively recruited to a questionnaire study following completion of dietitian-led lo...
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#1Heidi M Staudacher ('KCL': King's College London)H-Index: 20
#2Kevin Whelan ('KCL': King's College London)H-Index: 63
There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) die...
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#1Ruth Harvie (University of Otago)H-Index: 5
#2Alexandra Chisholm (University of Otago)H-Index: 21
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AIM: To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol (FODMAP) diet on irritable bowel syndrome (IBS) symptoms and quality of life (QoL). METHODS: Participants with IBS (Rome III) were randomized to two groups. Group I commenced a low FODMAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODMAP diet while group I started re-challenging foods. All patients completed the IBS SSS (IB...
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Cited By11
#1Massimo BelliniH-Index: 35
#2Sara TonarelliH-Index: 3
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#1Christopher J Black (University of Leeds)H-Index: 13
#2Heidi M Staudacher (Deakin University)H-Index: 20
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Objective null A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle and dietary advice fails. However, although the impact of a low FODMAP diet on individual IBS symptoms has been examined in some randomised controlled trials (RCTs), there has been no recent systematic assessment, and individual trials have studied numerous alternative or control interventions, meaning the best com...
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#2Jeongwon Choi (Yonsei University)
Last. Min Jung Chang (Yonsei University)
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We conducted a meta-analysis exploring the effect of a low fermentable oligo-, di-, monosaccharides, and polyols diet (LFD) on the overall symptoms, quality of life, and stool habits of irritable bowel syndrome (IBS) patients. The meta-analysis was performed using a random-effects method. The effect size was presented as weighted standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup analyses were conducted to determine the potential effects of covariates on the outcome. T...
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