Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis
- PMID: 25982757
- DOI: 10.1007/s00394-015-0922-1
Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis
Abstract
Background: Functional gastrointestinal symptoms such as abdominal pain, bloating, distension, constipation, diarrhea and flatulence have been noted in patients with irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The diversity of symptoms has meant that finding an effective treatment has been challenging with most treatments alleviating only the primary symptom. A novel treatment option for IBS and IBD currently generating much excitement is the low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet. The aim of this meta-analysis was to determine the evidence of the efficacy of such a diet in the treatment of functional gastrointestinal symptoms.
Methods: Electronic databases were searched through to March 2015 to identify relevant studies. Pooled odds ratios (ORs) and 95 % confidence intervals were calculated for the effect of a low FODMAP diet on the reduction in IBS [Symptoms Severity Score (SSS)] score and increase in IBS quality of life (QOL) score for both randomized clinical trials (RCTs) and non-randomized interventions using a random-effects model.
Results: Six RCTs and 16 non-randomized interventions were included in the analysis. There was a significant decrease in IBS SSS scores for those individuals on a low FODMAP diet in both the RCTs (OR 0.44, 95 % CI 0.25-0.76; I (2) = 35.52, p = 0.00) and non-randomized interventions (OR 0.03, 95 % CI 0.01-0.2; I (2) = 69.1, p = 0.02). In addition, there was a significant improvement in the IBS-QOL score for RCTs (OR 1.84, 95 % CI 1.12-3.03; I (2) = 0.00, p = 0.39) and for non-randomized interventions (OR 3.18, 95 % CI 1.60-6.31; I (2) = 0.00, p = 0.89). Further, following a low FODMAP diet was found to significantly reduce symptom severity for abdominal pain (OR 1.81, 95 % CI 1.13-2.88; I (2) = 0.00, p = 0.56), bloating (OR 1.75, 95 % CI 1.07-2.87; I (2) = 0.00, p = 0.45) and overall symptoms (OR 1.81, 95 % CI 1.11-2.95; I (2) = 0.00, p = 0.4) in the RCTs. In the non-randomized interventions similar findings were observed.
Conclusion: The present meta-analysis supports the efficacy of a low FODMAP diet in the treatment of functional gastrointestinal symptoms. Further research should ensure studies include dietary adherence, and more studies looking at greater number of patients and long-term adherence to a low FODMAP diet need to be conducted.
Keywords: Diet; FGID; FODMAP; Functional gastrointestinal disorders; Meta-analysis; Symptoms.
Similar articles
-
Low fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial.J Gastroenterol Hepatol. 2018 Jun;33(6):1192-1199. doi: 10.1111/jgh.14051. Epub 2018 Feb 21. J Gastroenterol Hepatol. 2018. PMID: 29159993 Clinical Trial.
-
Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis.Nutrition. 2018 Jan;45:24-31. doi: 10.1016/j.nut.2017.07.004. Epub 2017 Jul 13. Nutrition. 2018. PMID: 29129233 Review.
-
Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis.Nutrients. 2017 Aug 26;9(9):940. doi: 10.3390/nu9090940. Nutrients. 2017. PMID: 28846594 Free PMC article. Review.
-
Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies.PLoS One. 2017 Aug 14;12(8):e0182942. doi: 10.1371/journal.pone.0182942. eCollection 2017. PLoS One. 2017. PMID: 28806407 Free PMC article.
-
Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome.Aliment Pharmacol Ther. 2016 Sep;44(5):460-70. doi: 10.1111/apt.13726. Epub 2016 Jul 15. Aliment Pharmacol Ther. 2016. PMID: 27417338 Free PMC article. Clinical Trial.
Cited by
-
Effectiveness of Probiotic Use in Alleviating Symptoms of Irritable Bowel Syndrome: A Systematic Review.Cureus. 2024 Apr 15;16(4):e58306. doi: 10.7759/cureus.58306. eCollection 2024 Apr. Cureus. 2024. PMID: 38752062 Free PMC article. Review.
-
Prevalence, types, and risk factors of functional gastrointestinal diseases in Hainan Province, China.Sci Rep. 2024 Feb 24;14(1):4553. doi: 10.1038/s41598-024-55363-4. Sci Rep. 2024. PMID: 38402323 Free PMC article.
-
Nutrition and Chronobiology as Key Components of Multidisciplinary Therapeutic Interventions for Fibromyalgia and Associated Chronic Fatigue Syndrome: A Narrative and Critical Review.Nutrients. 2024 Jan 5;16(2):182. doi: 10.3390/nu16020182. Nutrients. 2024. PMID: 38257075 Free PMC article. Review.
-
Efficacy and safety of fecal microbiota transplantation for the treatment of irritable bowel syndrome: an overview of overlapping systematic reviews.Front Pharmacol. 2023 Oct 17;14:1264779. doi: 10.3389/fphar.2023.1264779. eCollection 2023. Front Pharmacol. 2023. PMID: 37915416 Free PMC article.
-
Nutraceuticals and biotics in pediatric gastrointestinal disorders.Eur J Clin Nutr. 2024 Feb;78(2):87-98. doi: 10.1038/s41430-023-01362-z. Epub 2023 Oct 24. Eur J Clin Nutr. 2024. PMID: 37875612 Review.
References
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources