Low-FODMAP Diet Improves Symptoms of IBS

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) reduced symptoms for irritable bowel syndrome (IBS), according to a study published in the January 2014 issue of Gastroenterology.

From April 2009 to June 2011, researchers at the Department of Medicine at Monash University in Australia observed 38 patients with similar demographics and diet. Thirty of the patients had IBS. To track symptoms IBS patients were subcategorized as being diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), having both diarrhea and constipation (IBS-M), or as having neither diarrhea nor constipation (IBS-U). For one week researchers closely oversaw patients’ unaltered diets.

“Participants then randomly were assigned to groups that received 21 days of either a diet low in FODMAPs or a typical Australian diet, followed by a washout period of at least 21 days, before crossing over to the alternate diet,” researchers explained.

Most of the food was provided by investigators during the interventional stage of research. During the low-FODMAP portion of the diet researchers aimed for an intake of less than 0.5 grams of FODMAPs per meal. Researchers tracked the effects of the new diet in several ways.

“Daily symptoms were rated using a 0- to 100-mm visual analogue scale,” the authors explained. Furthermore, “all stools were collected from days 17—21 and assessed for frequency, weight, water content, and King's Stool Chart rating.”

Authors found that the low-FODMPAs diet reduced functional gastrointestinal symptoms.

Additionally, IBS-D patients claimed an improvement with stool consistency under the low-FODMAP diet. F

Patients with IBS had reduced bloating, pain and flatulence. or patients without IBS the diet yielded little or no change in symptoms.

“Subjects with IBS had lower overall gastrointestinal symptom scores (22.8; 95% confidence interval, 16.7—28.8 mm) while on a diet low in FODMAPs, compared with the Australian diet (44.9; 95% confidence interval, 36.6–53.1 mm; P < .001) and the subjects' habitual diet,” the researchers wrote.

However, researchers warned that while a low-FODMAP diet could be successful, it may not be realistic for all IBS patients to take on.

“Although providing such a controlled diet is a strength in examining the role of FODMAPs in IBS, such a study design is not representative of reality,” the authors wrote. “Dietary restriction would have more varying degrees of compliance and depend on the patients’ degree of understanding, food choices, and motivation for altering dietary habits, as well as the dietitians’ advice on level of FODMAP restriction required.”