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Low FODMAP diet most likely to improve symptoms for patients with irritable bowel syndrome
Clinical Question
Is a low FODMAP diet effective for the treatment of irritable bowel syndrome?
Bottom line
This network meta-analysis of the admittedly sparse literature concluded that compared with other diets, a low FODMAP diet (avoiding fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) is most likely to be effective for patients with IBS. With a low FODMAP diet, all offending foods are removed from the diet for 4 to 6 weeks, followed by a gradual and systematic reintroduction of foods to identify those that the patient can tolerate. 1a-
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Self-funded or unfunded
Setting: Outpatient (any)
Synopsis
This was a network meta-analysis of 13 studies including 944 patients with irritable bowel syndrome (IBS). The studies were small (range: 30 to 110 patients), used the Rome III criteria to identify eligible patients, and compared a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) with usual diet, dietician advice, or the diet recommend by the British Dietetic Association (BDA). Nine trials were at low risk of bias across all domains other than double masking. Most studies enrolled patients with both IBS with constipation and IBS with diarrhea. The network meta-analysis combined direct and indirect comparisons and concluded that the low FODMAP diet was most likely to reduce pain, reduce bloating and distention, and improve bowel symptoms, and was also most likely to improve global IBS symptoms. The low FODMAP diet was superior to both the patient's usual diet and to the BDA recommended diet.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
low FODMAP DIET
HELPFUL IN IBS