Natalia Pedersen, Nynne Nyboe Andersen, Zsuzsanna Végh, Lisbeth Jensen, Dorit Vedel Ankersen, Maria Felding, Mette Hestetun Simonsen, Johan Burisch, Pia Munkholm
Journal: World journal of gastroenterology 2015;20(43):16215-26
PMID: 25473176
The low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (FODMAP) diet was developed based on poor absorption of short-chain carbohydrates in the small intestines of patients with irritable bowel syndrome (IBS). Probiotics have been shown to reduce symptoms in children with intestinal disorders but has not been explored in adults with IBS. The aim of this study was to investigate the efficacy of a low FODMAP diet (LFD) and the probiotic Lactobacillus rhamnosus GG (LGG) in 123 adults with IBS. Participants were randomised to consume a LFD, LGG or Western diet for six weeks, and self-reported symptom severity and quality of life through a web-based application. This study demonstrated that both a low FODMAP diet and consuming the probiotic Lactobacillus rhamnosus GG were effective in reducing symptom severity in patients with the IBS-A and IBS-D subtypes. The authors conclude that LFD and LGG should be recommended for patients with these IBS subtypes, and that web-based monitoring appeared to be feasible among patients for this population.
AIM
To investigate the effects of a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (LFD) and the probiotic Lactobacillus rhamnosus GG (LGG) in irritable bowel syndrome (IBS).
METHODS
Randomised, unblinded controlled trial on the effect of 6-wk treatment with LFD, LGG or a normal Danish/Western diet (ND) in patients with IBS fulfilling Rome III diagnostic criteria, recruited between November 2009 and April 2013. Patients were required to complete on a weekly basis the IBS severity score system (IBS-SSS) and IBS quality of life (IBS-QOL) questionnaires in a specially developed IBS web self-monitoring application. We investigated whether LFD or LGG could reduce IBS-SSS and improve QOL in IBS patients.
RESULTS
One hundred twenty-three patients (median age 37 years, range: 18-74 years), 90 (73%) females were randomised: 42 to LFD, 41 to LGG and 40 to ND. A significant reduction in mean ± SD of IBS-SSS from baseline to week 6 between LFD vs LGG vs ND was revealed: 133 ± 122 vs 68 ± 107, 133 ± 122 vs 34 ± 95, P < 0.01. Adjusted changes of IBS-SSS for baseline covariates showed statistically significant reduction of IBS-SSS in LFD group compared to ND (IBS-SSS score 75; 95%CI: 24-126, P < 0.01), but not in LGG compared to ND (IBS-SSS score 32; 95%CI: 18-80, P = 0.20). IBS-QOL was not altered significantly in any of the three groups: mean ± SD in LFD 8 ± 18 vs LGG 7 ± 17, LFD 8 ± 18 vs ND 0.1 ± 15, P = 0.13.
CONCLUSION
Both LFD and LGG are efficatious in patients with IBS.
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