Subhajit Nan, Amity University, Kolkata.
Scientists have recently conducted clinical trials and made a critical meta-analysis on the effect of FODMAPS diet (abbreviated as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). These are considered to influence the stool habits and the overall quality of life of the patients suffering from irritable bowel syndrome (IBS). Subgroup analyses were also carried out to determine the potential effects of variations on the outcome.
What is IBS?
Irritable bowel syndrome, abbreviated as IBS, is a chronic gastrointestinal disorder that is normally characterized by changes in bowel habits, coupled with intense stomach pain. 5% to 20% of the general population is estimated to suffer from this disease. It affects females more than males. The chronic nature of IBS with recurring and progressively worsening symptoms has a negative impact on the quality of life, productivity in work, and social functioning of the patients. IBS can cause impairment in the gut and brain connection, intestines becoming less motile, mild inflammation, gut hypersensitivity, a threat to useful microorganisms in the gut, genetic disorders, stress, and dietary changes.
What is this study all about?
Since times immemorial, the treatment of Irritable Bowel Syndrome has prioritized pharmacological medications, such as laxatives and antidepressants. Recently, however, dietary interventions and cognitive therapies have gained significant traction. Diets containing lesser fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, collectively known as FODMAPs, have been projected as an important dietary therapy in treating IBS.
Recently, scientists found that a Low-FODMAP Diet or LFD significantly reduced IBS severity and increased the quality of life when compared with a control diet in a meta-analysis. The main objective of this study was to provide the latest meta-analysis that compared an LFD group to a control group. The control group was given not only the traditional high FODMAP diets, but also structured dietary interventions (like a low-lactose diet and gluten-free diet), supplementation (like prebiotics and probiotics), and lifestyle changes (like doing yoga and hypnotherapy) for reducing the symptoms of IBS and improve the quality of life. The scientists also studied the effect of LFD on stool habits, like stool frequency and stool consistency.
Salient Features of the study:
This updated meta-analysis includes the analysis of Severity Scoring System or IBS-SSS subscale score and bowel habits. It was found that LFD showed a moderate reduction in the severity of IBS symptoms compared to the control interventions.
Change of stool habits was observed in patients with diarrhea predominant IBS or IBS-D. A significant decrease in stool frequency and a significant improvement in stool consistency in the LFD group was observed in them, compared to that in the control group. They explained that LFD reduces the osmotic pressure exerted by FODMAPs in the lumen of the small intestine and reduces diarrhoea in such patients.
They also tried to evaluate the effect of LFD on stool habits of patients with all IBS subtypes except constipation-predominant IBS or IBS-C, but it was difficult to interpret clinically as the mean difference in the data could not give a proper value.
The subgroup analyses demonstrated that IBS symptoms improved and became less severe with different proportions of female populations. It also analyzed several IBS subtypes, durations of the study and various control interventions.
Limitations of the study:
This meta-analysis had certain limitations. Biasness can be found because of the lack of standardization in the constituting individual studies. The LFD implementation tends to vary across diverse geographical regions. The proportion of females and/or patients with different subtypes of IBS was not constant. In addition to this, some assessments and their subsequent outcomes were poorly explained.
Even though the scientists carried out the subgroup analyses, all the subgroups considered in the meta-analysis were relatively small. Hence, the outcomes must be interpreted cautiously. Further, it must be considered that the binary endpoint used in this study may not be effective to detect a reduction in symptoms. As a result, it calls for future studies with a larger sample size to detect statistically significant differences between subgroups.
Conclusion:
In conclusion, we can say that LFD has significantly reduced the severity of IBS symptoms. It also significantly improved the quality of life in patients with IBS. However, the impact of food avoidance on the quality of life should be properly investigated in LFD-adopting patients. The frequency and consistency of stool habits also improved in IBS-D patients. Now whether LFD is the most effective treatment option is still debatable. That should be confirmed by future clinical trials and studies.
Also read: Unveiling the features of within-host dynamics in malaria
Reference:
- Hahn, J., Choi, J., & Chang, M. J. (2021). Effect of low fodmaps diet on irritable bowel syndromes: A systematic review and meta-analysis of clinical trials. Nutrients, 13(7), 2460. https://doi.org/10.3390/nu13072460
2 thoughts on “Treating Irritable Bowel Syndrome with Low FODMAPs Diet”