Poster Presentation Gastrodiet 2015

Low FODMAP advice for patients with irritable bowel syndrome: Long-term outcomes for symptoms and dietary intake (#31)

Lee Martin 1 , Clare Jansen 1 , Leah Seamark 2 , Marianne Williams 2 , Heidi Staudacher 1 , Peter Irving 3 , Kevin Whelan 1 , Miranda Lomer 3
  1. King's College London, London, United Kingdom
  2. Community Dietetics Service, Somerset Partnership NHS Foundation Trust , Somerset, United Kingdom
  3. Guy's and St Thomas' NHS Foundation Trust & King's College London, London, United Kingdom

Introduction: A low fermentable carbohydrate (FODMAP) diet reduces symptoms of irritable bowel syndrome (IBS) and is routinely used in clinical practice. Comprehensive low FODMAP education administered by a dietitian incorporates FODMAP restriction for 4-8 weeks followed by FODMAP reintroduction to test individual tolerance. Patients are empowered to self-manage their diet and symptoms, however whether this approach is effective long-term is unknown. Previous research has indicated that a low FODMAP diet is associated with lower calcium intake.

Aims & Methods: This study aimed to assess the long-term effectiveness of the low FODMAP diet and the impact on dietary intake in patients with IBS. Patients with IBS (n=375) were invited to take part in a prospective questionnaire study after comprehensive low FODMAP education. Symptoms were assessed at baseline before low FODMAP education, following FODMAP restriction (4-8 weeks) and following FODMAP reintroduction (6-18 months) using the global symptom question “Do you currently have satisfactory relief of your gut symptoms?” and the Gastrointestinal Symptom Rating Scale. Dietary intake was measured using a validated FODMAP FFQ.

Results: Questionnaires from 103 patients were received (age: mean [sd]; 48 [15] years, female: n=76). Following initial FODMAP restriction, 63 (61%) patients reported satisfactory relief. Of these, 44/63 (70%) continued to report satisfactory relief following FODMAP reintroduction in the long term. In the long term, 84 patients continued to follow an adapted low FODMAP diet. Mean [sd] calcium intake was 1130mg/d [682] and 73 (71%) patients met the calcium dietary reference value.

Conclusion: The majority of patients report satisfactory relief of symptoms following FODMAP restriction and have satisfactory relief in the long term indicating that low FODMAP education is useful for long-term symptom control and self-management. Most patients continue to follow an adapted low FODMAP diet and meet their calcium requirements.

Funding: Dr. Schär part-funded this study