Beyond Irritable Bowel Syndrome: The Efficacy of the Low Fodmap Diet for Improving Symptoms in Inflammatory Bowel Diseases and Celiac Disease

Dig Dis. 2018;36(4):271-280. doi: 10.1159/000489487. Epub 2018 May 15.

Abstract

Background and aim: To evaluate the usefulness of a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet on patients with irritable bowel syndrome (IBS), non-active inflammatory bowel diseases (IBD), and celiac disease (CD) on a gluten-free diet (GFD).

Methods: Dietetic interventional prospective study. IBS, IBD, and CD subjects were evaluated to check if they fulfilled the Rome III criteria. Each subject was educated to follow a low FODMAP diet after being evaluated by filling out questionnaires that assessed the quality of life (QoL) and symptoms experienced (IBS-SSS and SF-36), and was reevaluated after 1 and 3 months.

Results: One hundred twenty-seven subjects were enrolled: 56 with IBS, 30 with IBD, and 41 with CD. IBS-SSS showed that abdominal symptoms improved after 1 and 3 months of diet in all subjects, with significant difference among the 3 groups at T0 (average scores IBS: 293 ± 137, IBD: 206 ± 86, CD: 222 ± 65, p < 0.001), but no difference at T3 (IBS: 88 ± 54, IBD: 73 ± 45, CD: 77 ± 49, p = ns). By analyzing the SF-36 questionnaire, we did not observe any difference between the 3 groups, in terms of response to diet (p = ns), we observed a clinical improvement from T0 to T3 for most of the questionnaire's domains.

Conclusions: A low FODMAP diet could be a valid option to counter -abdominal symptoms in patients with IBS, non-active IBD, or CD on a GFD, and thus, improve their QoL and social -relations.

Keywords: Celiac disease; Diet; Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; Inflammatory bowel diseases; Irritable bowel syndrome.

MeSH terms

  • Adult
  • Aged
  • Celiac Disease / diet therapy*
  • Diet, Gluten-Free
  • Disaccharides / therapeutic use*
  • Female
  • Fermentation
  • Humans
  • Inflammatory Bowel Diseases / diet therapy*
  • Irritable Bowel Syndrome / diet therapy*
  • Male
  • Middle Aged
  • Monosaccharides / therapeutic use*
  • Oligosaccharides / therapeutic use*
  • Polymers / therapeutic use*
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult

Substances

  • Disaccharides
  • Monosaccharides
  • Oligosaccharides
  • Polymers
  • polyol