Premium
Long‐term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome
Author(s) -
Staudacher Heidi M.,
Rossi Megan,
Kaminski Thomas,
Dimidi Eirini,
Ralph Frances S. E.,
Wilson Bridgette,
Martin Lee D.,
Louis Petra,
Lomer Miranda C.E,
Irving Peter M.,
Whelan Kevin
Publication year - 2022
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.14241
Subject(s) - irritable bowel syndrome , medicine , gastroenterology , quality of life (healthcare) , nursing
Background Short‐term trials demonstrate the low FODMAP diet improves symptoms of irritable bowel syndrome (IBS) but impacts nutrient intake and the gastrointestinal microbiota. The aim of this study was to investigate clinical symptoms, nutrient intake, and microbiota of patients with IBS 12 months after starting a low FODMAP diet. Methods Participants enrolled in a previous short‐term clinical trial and who had been through structured FODMAP restriction, reintroduction, and personalization were invited to participate in a follow‐up study at one time point at 12 months. Gastrointestinal symptoms, stool output, dietary intake, and quality of life were recorded. Stool samples were collected and analyzed for microbiota (qPCR) and short‐chain fatty acids (SCFA). Data were compared with baseline (prior to any intervention in the original clinical trial) using non‐parametric statistics. Key Results Eighteen participants were included in the study. Adequate relief of symptoms occurred in 5/18 (28%) at baseline and increased to 12/18 (67%) following long‐term personalized low FODMAP diet ( p = 0.039). There was a reduction in IBS‐SSS total score between baseline (median 227, IQR 99) and long term (154, 89; p < 0.001). Bifidobacteria abundance was not different between baseline (median 9.29 log10 rRNA genes/g, IQR 1.45) and long term (9.20 log10 rRNA genes/g, 1.41; p = 0.766, q = 0.906); however, there were lower concentrations of total SCFA, acetate, propionate, and butyrate. Conclusions In this long‐term analysis, two thirds of patients reported adequate relief of symptoms after 12 months of personalized low FODMAP diet that did not result in differences from baseline in Bifidobacteria. FODMAP reintroduction and personalization may normalize some of the effects of short‐term FODMAP restriction.