Long term impact of the low FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability and healthcare utilisation in irritable bowel syndrome: Long-term impact of the low FODMAP diet

Majella Marie O'Keeffe, Clare Jansen, Lee Martin, Marianne Williams, Leah Seamark, Heidi Maria Staudacher, Peter Irving, Kevin Whelan, Miranda Lomer

Research output: Contribution to journalArticlepeer-review

Abstract

Background The low FODMAP diet is a frequently used treatment for irritable bowel syndrome (IBS). Most research has focused on short-term FODMAP restriction however guidelines recommend that high FODMAP foods are reintroduced to individual tolerance. This study aimed to assess the long-term effectiveness of the low FODMAP diet following FODMAP reintroduction in IBS patients. Methods Patients with IBS were prospectively recruited to a questionnaire study following completion of dietitian-led low FODMAP education. At baseline and following FODMAP restriction (short-term) only gastrointestinal symptoms were measured as part of routine clinical care. Following FODMAP reintroduction, (long-term), symptoms, dietary intake, acceptability, food-related quality of life (QOL) and healthcare utilisation were assessed. Data were reported for patients who continued long-term FODMAP restriction (adapted FODMAP) and/or returned to a habitual diet (habitual). Key Results Of 103 patients, satisfactory relief of symptoms was reported in 12% at baseline, 61% at short-term follow-up and 57% at long-term follow-up. At long-term follow-up, 84 (82%) patients continued an ‘adapted FODMAP’ diet (total FODMAP intake mean 20.6, SD 14.9g/d) compared with 19 (18%) of patients following a ‘habitual’ diet (29.4, SD 22.9g/d, p=0.039). Nutritional adequacy was not compromised for either group. The ‘adapted FODMAP’ group reported the diet cost significantly more than the ‘habitual’ group (p<0.001) and affected social eating (p<0.01) but there was no effect on food-related QOL. Healthcare utilisation was similar between both groups. Conclusion and Inferences Low FODMAP education is effective for long-term IBS management, enables a nutritionally adequate diet and is broadly acceptable to patients.
Original languageEnglish
JournalNeurogastroenterology and Motility
Publication statusAccepted/In press - 9 Jun 2017

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