Long‐term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome

2021 ◽  
Author(s):  
Heidi M. Staudacher ◽  
Megan Rossi ◽  
Thomas Kaminski ◽  
Eirini Dimidi ◽  
Frances S. E. Ralph ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Irritable Bowel ◽  
Fodmap Diet

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

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2360 ◽  
Author(s):  
Massimo Bellini ◽  
Sara Tonarelli ◽  
Federico Barracca ◽  
Riccardo Morganti ◽  
Andrea Pancetti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Nutritional Adequacy ◽  
Related Quality ◽  
Short And Long Term ◽  
Irritable Bowel ◽  
Fodmap Diet

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.

scholarly journals Effectiveness and applicability of low FODMAP diet in the irritable bowel syndrome: Preliminary results of a prospective study

2019 ◽  
pp. 4-9
Keyword(s):  
Irritable Bowel Syndrome ◽  
Prospective Study ◽  
Life Quality ◽  
Treatment Efficiency ◽  
Therapeutic Modalities ◽  
Frequency Survey ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
A Prospective Study

Abstract: Introduction: Irritable bowel syndrome (IBS) is a very common entity that alters patient’s life quality worldwide. Several therapeutic modalities are available with variable results. Recently, the low-FODMAP diet effect on IBS symptoms has been proven. The aim of our study was to study the efficiency of this diet and to assess its applicability in a Tunisian IBS group of patients. Methods: A longitudinal, prospective study including 34 patients with IBS was conducted. Patients responded to a food frequency survey and had to follow a low FODMAP diet with a dietary guide education for 3 weeks. After the diet, a telephone questionnaire was conducted to evaluate adherence and treatment efficiency. Results: Mean of the population age was 56.5 (21 – 83 years) with a sex ratio of almost 1⁄4. The initial food survey showed a large consumption of white bread and fruits. Tolerance to rich in FODMAP foods was variable among patients. Up to 97% of patients adhered to the low FODMAP diet. A decrease in abdominal pain in 88% of cases and in bloating in 64.7% of cases (p = 0.007) were noted after the diet. Conclusion: In our patients, the low FODMAP diet showed satisfactory results with good adherence, and improvement of IBS symptoms. However, it is important to note the difficulty of a long-term diet in a population with a variable alimentary habit. Key words: low FODMAP diet; irritable bowel syndrome, applicability, Tunisia

scholarly journals Long-Term Effects of a Web-Based Low-FODMAP Diet Versus Probiotic Treatment for Irritable Bowel Syndrome, Including Shotgun Analyses of Microbiota: Randomized, Double-Crossover Clinical Trial

10.2196/30291 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e30291
Author(s):  
Dorit Vedel Ankersen ◽  
Petra Weimers ◽  
Mette Bennedsen ◽  
Anne Birgitte Haaber ◽  
Eva Lund Fjordside ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Web Application ◽  
Metagenomic Sequencing ◽  
Web Based ◽  
Probiotic Treatment ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Term Management ◽  
The Web

Background The long-term management of irritable bowel syndrome (IBS) poses many challenges. In short-term studies, eHealth interventions have been demonstrated to be safe and practical for at-home monitoring of the effects of probiotic treatments and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). IBS has been linked to alterations in the microbiota. Objective The aim of this study was to determine whether a web-based low-FODMAP diet (LFD) intervention and probiotic treatment were equally good at reducing IBS symptoms, and whether the response to treatments could be explained by patients’ microbiota. Methods Adult IBS patients were enrolled in an open-label, randomized crossover trial (for nonresponders) with 1 year of follow-up using the web application IBS Constant Care (IBS CC). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Denmark. Patients received either VSL#3 for 4 weeks (2 × 450 billion colony-forming units per day) or were placed on an LFD for 4 weeks. Patients responding to the LFD were reintroduced to foods high in FODMAPs, and probiotic responders received treatments whenever they experienced a flare-up of symptoms. Treatment response and symptom flare-ups were defined as a reduction or increase, respectively, of at least 50 points on the IBS Severity Scoring System (IBS-SSS). Web-based ward rounds were performed daily by the study investigator. Fecal microbiota were analyzed by shotgun metagenomic sequencing (at least 10 million 2 × 100 bp paired-end sequencing reads per sample). Results A total of 34 IBS patients without comorbidities and 6 healthy controls were enrolled in the study. Taken from participating subjects, 180 fecal samples were analyzed for their microbiota composition. Out of 21 IBS patients, 12 (57%) responded to the LFD and 8 (38%) completed the reintroduction of FODMAPs. Out of 21 patients, 13 (62%) responded to their first treatment of VSL#3 and 7 (33%) responded to multiple VSL#3 treatments. A median of 3 (IQR 2.25-3.75) probiotic treatments were needed for sustained symptom control. LFD responders were reintroduced to a median of 14.50 (IQR 7.25-21.75) high-FODMAP items. No significant difference in the median reduction of IBS-SSS for LFD versus probiotic responders was observed, where for LFD it was –126.50 (IQR –196.75 to –76.75) and for VSL#3 it was –130.00 (IQR –211.00 to –70.50; P>.99). Responses to either of the two treatments were not able to be predicted using patients’ microbiota. Conclusions The web-based LFD intervention and probiotic treatment were equally efficacious in managing IBS symptoms. The response to treatments could not be explained by the composition of the microbiota. The IBS CC web application was shown to be practical, safe, and useful for clinical decision making in the long-term management of IBS. Although this study was underpowered, findings from this study warrant further research in a larger sample of patients with IBS to confirm these long-term outcomes. Trial Registration ClinicalTrials.gov NCT03586622; https://clinicaltrials.gov/ct2/show/NCT03586622

scholarly journals Long-Term Effects of a Web-Based Low-FODMAP Diet Versus Probiotic Treatment for Irritable Bowel Syndrome, Including Shotgun Analyses of Microbiota: Randomized, Double-Crossover Clinical Trial (Preprint)

2021 ◽  
Author(s):  
Dorit Vedel Ankersen ◽  
Petra Weimers ◽  
Mette Bennedsen ◽  
Anne Birgitte Haaber ◽  
Eva Lund Fjordside ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Web Application ◽  
Metagenomic Sequencing ◽  
Web Based ◽  
Probiotic Treatment ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Term Management ◽  
The Web

BACKGROUND The long-term management of irritable bowel syndrome (IBS) poses many challenges. In short-term studies, eHealth interventions have been demonstrated to be safe and practical for at-home monitoring of the effects of probiotic treatments and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). IBS has been linked to alterations in the microbiota. OBJECTIVE The aim of this study was to determine whether a web-based low-FODMAP diet (LFD) intervention and probiotic treatment were equally good at reducing IBS symptoms, and whether the response to treatments could be explained by patients’ microbiota. METHODS Adult IBS patients were enrolled in an open-label, randomized crossover trial (for nonresponders) with 1 year of follow-up using the web application IBS Constant Care (IBS CC). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Denmark. Patients received either VSL#3 for 4 weeks (2 × 450 billion colony-forming units per day) or were placed on an LFD for 4 weeks. Patients responding to the LFD were reintroduced to foods high in FODMAPs, and probiotic responders received treatments whenever they experienced a flare-up of symptoms. Treatment response and symptom flare-ups were defined as a reduction or increase, respectively, of at least 50 points on the IBS Severity Scoring System (IBS-SSS). Web-based ward rounds were performed daily by the study investigator. Fecal microbiota were analyzed by shotgun metagenomic sequencing (at least 10 million 2 × 100 bp paired-end sequencing reads per sample). RESULTS A total of 34 IBS patients without comorbidities and 6 healthy controls were enrolled in the study. Taken from participating subjects, 180 fecal samples were analyzed for their microbiota composition. Out of 21 IBS patients, 12 (57%) responded to the LFD and 8 (38%) completed the reintroduction of FODMAPs. Out of 21 patients, 13 (62%) responded to their first treatment of VSL#3 and 7 (33%) responded to multiple VSL#3 treatments. A median of 3 (IQR 2.25-3.75) probiotic treatments were needed for sustained symptom control. LFD responders were reintroduced to a median of 14.50 (IQR 7.25-21.75) high-FODMAP items. No significant difference in the median reduction of IBS-SSS for LFD versus probiotic responders was observed, where for LFD it was –126.50 (IQR –196.75 to –76.75) and for VSL#3 it was –130.00 (IQR –211.00 to –70.50; <i>P</i>&gt;.99). Responses to either of the two treatments were not able to be predicted using patients’ microbiota. CONCLUSIONS The web-based LFD intervention and probiotic treatment were equally efficacious in managing IBS symptoms. The response to treatments could not be explained by the composition of the microbiota. The IBS CC web application was shown to be practical, safe, and useful for clinical decision making in the long-term management of IBS. Although this study was underpowered, findings from this study warrant further research in a larger sample of patients with IBS to confirm these long-term outcomes. CLINICALTRIAL ClinicalTrials.gov NCT03586622; https://clinicaltrials.gov/ct2/show/NCT03586622

scholarly journals Significance and efficacy of low-FODMAP diet for treating irritable bowel syndrome

2020 ◽  
Vol 16 (4) ◽  
pp. 355-361
Author(s):  
Michalina Mróz ◽  
◽  
Emilia Korek ◽  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Terminal Illness ◽  
Symptomatic Relief ◽  
Gastrointestinal Disorder ◽  
Gas Production ◽  
Bowel Movements ◽  
Stool Form ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable bowel syndrome is the most common chronic functional gastrointestinal disorder that is characterised by abdominal pain associated with defecation, accompanied by a change in the frequency of bowel movements or stool form. Although it has a significant impact on a patient’s quality of life, it is not a terminal illness. Lately, there has been an increasing interest in nutritional treatment for irritable bowel syndrome, especially a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP). These carbohydrates ferment easily, they are poorly absorbed and have high osmotic pressure whereby they can trigger gastrointestinal disturbances in patients with irritable bowel syndrome. Many studies demonstrated that FODMAP restriction reduces the osmotic load and gas production in the small intestine and the colon, ensuring symptomatic relief in patients suffering from irritable bowel syndrome. Long-term health effects of using a low-FODMAP diet are not known, therefore, stringent FODMAP restriction is not recommended because of risks of inadequate nutrient intake and potential harmful effects from altered gut microbiota. In summary, there is evidence to strongly support the efficacy of a low-FODMAP diet in the treatment of irritable bowel syndrome. However, further and more detailed studies are required to understand any potential side effects of long-term restriction of FODMAP.

The long‐term effect and adherence of a low fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) diet in patients with irritable bowel syndrome

2019 ◽  
Vol 33 (2) ◽  
pp. 159-169 ◽  
Author(s):  
A. Weynants ◽  
L. Goossens ◽  
M. Genetello ◽  
D. De Looze ◽  
M. Van Winckel
Keyword(s):  
Irritable Bowel Syndrome ◽  
Term Effect ◽  
Long Term Effect ◽  
Irritable Bowel ◽  
Fodmap Diet

scholarly journals Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Gastrointestinal Disorder ◽  
Additional Energy ◽  
Nutritional Advice ◽  
Intestinal Dysbiosis ◽  
Gi Symptoms ◽  
Mutualistic Relationship ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.

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