scholarly journals Effects of Low-FODMAP diet on irritable bowel symptoms in patients with quiescent inflammatory bowel disease：A SystematicReview and Meta-analysis

2022 ◽  
Author(s):  
Baijian Gu ◽  
◽  
Jianhua Zhou ◽  
Zhe Yu ◽  
Chong Shi ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Bowel Symptoms ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Fodmap Diet

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

2017 ◽  
Vol 23 (18) ◽  
pp. 3356 ◽  
Author(s):  
Natalia Pedersen ◽  
Dorit Vedel Ankersen ◽  
Maria Felding ◽  
Henrik Wachmann ◽  
Zsuzsanna Végh ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Bowel Symptoms ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Fodmap Diet

scholarly journals Irritable bowel syndrome: new insights into symptom mechanisms and advances in treatment

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 780 ◽  
Author(s):  
Robin Spiller
Keyword(s):  
Irritable Bowel Syndrome ◽  
New Agents ◽  
Enteric Nerves ◽  
Inflammatory Bowel ◽  
Magnetic Resonance Imaging Mri ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
And Function ◽  
The Impact

Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future.

P059 SIGNIFICANTLY INCREASED MUCOSAL EOSINOPHILS IN PATIENTS WITH POST-IBD IBS-D SYNDROME MAY HAVE A NEW AVENUE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Mukaddes Tozlu ◽  
Ilimbek Beketaev ◽  
Mamoun Younes ◽  
Wasim Dar ◽  
Changqing Ju ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Genetic Components ◽  
Pooled Prevalence ◽  
Single Center Study ◽  
New Finding ◽  
History Of ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Near Future

Abstract Introduction Inflammatory bowel disease (IBD) patients in remission who present with irritable bowel syndrome with diarrhea (IBS-D) like symptoms pose a diagnostic and therapeutic dilemma that is called post-IBD IBS-D. This syndrome was first reported by Isgar et al. who documented IBS-type symptoms in 33% of their patients with chronic ulcerative colitis (CUC) in remission in 1983. In their meta-analysis of 13 studies incorporating 1,703 patients, Halpin and Ford in 2012 calculated a pooled prevalence of 35% for IBS symptoms among IBD subjects in remission. The post-IBD IBS-D syndrome represents a source of considerable stress, incurs morbidity and impairs quality of life of these patients. The etiology of this syndrome is unknown and may be multifactorial such as environmental, psychological, GI motility disarray, genetic components and possibly by gut microbiome. Methods We conducted a retrospective, single-center study of patients with history of IBD and IBS-D like symptoms. The demographic characteristics, type of IBD, colonoscopy, biopsy findings and empirical medical management outcome were analyzed. Results We have found significantly increased mucosal eosinophils (>50 HPF in both side of the colon examined) in our patients with post-IBD IBS-D syndrome. In this study, 15 CUC patients and 20 Crohn’s disease patients with this syndrome were investigated and showed no clinical, serological, mucosal or microscopic IBD activity. These patients had non-bloody diarrhea (5–20 x daily), lower abdominal cramps (%90), mild weight loss (4–6 lbs) and fecal incontinence (%25) who were placed on the GI-hypoallergenic diet and budesonide therapy. Sixty seven percent of these 35 patients with post-IBD IBS-D responded well clinically to this management. Increased mucosal eosinophils in these patients with post-IBD IBS-D may have eosinophilic colopathy that may be related to intestinal permeability disarray. The epithelium in these IBD patients who are in remission may have the production of pro-inflammatory cytokines by the eosinophils, especially IL-23 and IL-33. This interesting area investigation is in progress by our research faculty. Conclusion In summary, this is an exciting new finding that significantly increased mucosal eosinophils in our patients with post-IBD IBS-D syndrome may have a new avenue, eosinophilic colopathy. Interestingly, these patients have responded to the GI-hypoallergenic diet and budesonide therapy. Obviously, we need more patients in the near future with longer follow-up and we hope that the other investigators may confirm our findings.

scholarly journals Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis

Gut ◽  
2021 ◽  
pp. gutjnl-2021-325214
Author(s):  
Christopher J. Black ◽  
Heidi M. Staudacher ◽  
Alexander C. Ford
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Meta Analysis ◽  
Tertiary Care ◽  
Bowel Habit ◽  
Dietary Advice ◽  
Abdominal Bloating ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
The Impact

ObjectiveA 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 comparator is unclear. We performed a network meta-analysis addressing these uncertainties.DesignWe searched the medical literature through to 2 April 2021 to identify RCTs of a low FODMAP diet in IBS. Efficacy was judged using dichotomous assessment of improvement in global IBS symptoms or improvement in individual IBS symptoms, including abdominal pain, abdominal bloating or distension, and bowel habit. Data were pooled using a random effects model, with efficacy reported as pooled relative risks (RRs) with 95% CIs, and interventions ranked according to their P-score.ResultsWe identified 13 eligible RCTs (944 patients). Based on failure to achieve an improvement in global IBS symptoms, a low FODMAP diet ranked first vs habitual diet (RR of symptoms not improving=0.67; 95% CI 0.48 to 0.91, P-score=0.99), and was superior to all other interventions. Low FODMAP diet ranked first for abdominal pain severity, abdominal bloating or distension severity and bowel habit, although for the latter it was not superior to any other intervention. A low FODMAP diet was superior to British Dietetic Association (BDA)/National Institute for Health and Care Excellence (NICE) dietary advice for abdominal bloating or distension (RR=0.72; 95% CI 0.55 to 0.94). BDA/NICE dietary advice was not superior to any other intervention in any analysis.ConclusionIn a network analysis, low FODMAP diet ranked first for all endpoints studied. However, most trials were based in secondary or tertiary care and did not study effects of FODMAP reintroduction and personalisation on symptoms.

scholarly journals Effectiveness of Fiber Supplementation for Gastrointestinal Function: An Umbrella Review of Meta-Analyses

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1133-1133
Author(s):  
Marc McRae
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Umbrella Review ◽  
Funding Sources ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Meta Analyses

Abstract Objectives To determine if published meta-analyses support the use of fiber supplementation in the treatment of constipation and the dietary support for gastrointestinal disorders such as irritable bowel syndrome, and inflammatory bowel disease. Methods A PubMed search from January 1, 1980 to November 30, 2019 was conducted with the following search strategy: (fiber OR fibre) AND (meta-analysis OR systematic review) AND (constipation OR irritable bowel syndrome OR inflammatory bowel disease). Meta-analyses that provided quantitative statistical analysis with a measured effect size were retrieved and accepted into this review. The following was extracted and entered into an Excel spreadsheet: number of publications included in the meta-analysis, number of total participants, fiber type and daily dose, pooled treatment effects for clinical endpoints and/or summary relative risks (RR's). Results Thirteen meta-analyses support dietary fiber supplementation for patients with constipation and irritable bowel syndrome, but the significant heterogeneity and publication bias undermines the support for using dietary fiber supplementation on these conditions. Conclusions This umbrella review of meta-analyses finds some benefits for recommending fiber supplementation to patients with constipation and irritable bowel syndrome, but significant heterogeneity and publication bias undermines this support. Funding Sources No funding sources were utilized.

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