Journal article
Treatment efficacy of a low FODMAP diet compared to a low lactose diet in IBS patients: A randomized, cross-over designed study.
- Krieger-Grübel C Department of Gastroenterology/Hepatology, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, St.Gallen, 9007, Switzerland. Electronic address: claudia.krieger@kssg.ch.
- Hutter S Department of Internal Medicine, Spital Männedorf, Asylstrasse 10, Männedorf, 8708, Switzerland.
- Hiestand M Department of Gastroenterology/Hepatology, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, St.Gallen, 9007, Switzerland.
- Brenner I Department of Gastroenterology/Hepatology, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, St.Gallen, 9007, Switzerland.
- Güsewell S Clinical Trial Unit, Kantonsspital St.Gallen, Rorschacherstrasse 95, St.Gallen, 9007, Switzerland.
- Borovicka J Department of Gastroenterology/Hepatology, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, St.Gallen, 9007, Switzerland.
- 2020-11-13
Published in:
- Clinical nutrition ESPEN. - 2020
English
BACKGROUND AND OBJECTIVE
A low FODMAP diet (LFD) has become a standard treatment in irritable bowel syndrome (IBS) patients. Compliant adherence to a LFD is challenging. We investigated the effect of a LFD compared to a less restrictive low lactose diet (LLD) in a randomized cross-over trial with IBS patients.
METHODS
Twenty-nine IBS patients were randomly assigned to two groups. After a run-in phase of 14 days, patients received 21 days of either a LFD or LLD. This intervention was followed by a washout period of 21 days before crossing over to the alternate diet. Dietician led diet instruction was given continuously. An IBS Severity Scoring System (IBS-SSS) was filled in at the end of each study period. To enhance study adherence, daily symptoms were assessed using a Visual Analog Scale (VAS).
RESULTS
IBS patients, irrespective of lactase deficiency, had a significantly reduced IBS-SSS score after both diets (LFD p = 0.002, LLD p = 0.007) without significant difference. On both diets, patients reported that IBS had less impact on their daily life compared to the time before the study (p < 0.01). On daily assessment, IBS patients on LFD reported significantly less abdominal pain (median VAS difference to baseline -0.8 (-2.8 to 2.7, p = 0.03) and less bloating (-0.5 (-4.1 to 3.4, p = 0.02) than patients on the LLD.
CONCLUSION
Both diets improved the overall IBS severity significantly and patients' preference of the two diets was similar. LFD but not LLD effectively reduced pain and bloating in patients with IBS.
A low FODMAP diet (LFD) has become a standard treatment in irritable bowel syndrome (IBS) patients. Compliant adherence to a LFD is challenging. We investigated the effect of a LFD compared to a less restrictive low lactose diet (LLD) in a randomized cross-over trial with IBS patients.
METHODS
Twenty-nine IBS patients were randomly assigned to two groups. After a run-in phase of 14 days, patients received 21 days of either a LFD or LLD. This intervention was followed by a washout period of 21 days before crossing over to the alternate diet. Dietician led diet instruction was given continuously. An IBS Severity Scoring System (IBS-SSS) was filled in at the end of each study period. To enhance study adherence, daily symptoms were assessed using a Visual Analog Scale (VAS).
RESULTS
IBS patients, irrespective of lactase deficiency, had a significantly reduced IBS-SSS score after both diets (LFD p = 0.002, LLD p = 0.007) without significant difference. On both diets, patients reported that IBS had less impact on their daily life compared to the time before the study (p < 0.01). On daily assessment, IBS patients on LFD reported significantly less abdominal pain (median VAS difference to baseline -0.8 (-2.8 to 2.7, p = 0.03) and less bloating (-0.5 (-4.1 to 3.4, p = 0.02) than patients on the LLD.
CONCLUSION
Both diets improved the overall IBS severity significantly and patients' preference of the two diets was similar. LFD but not LLD effectively reduced pain and bloating in patients with IBS.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1016/j.clnesp.2020.09.020
- PMID 33183577
- Persistent URL
- https://folia.unifr.ch/global/documents/77204
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