381 Efficacy of a New Approach to the Reintroduction Phase of the Low-Fodmap Diet in Ibs

Houte, Karen Van den; Colomier, Esther; Mariën, Zoë; Schol, Jolien; Jasmien, Van den Bergh; Julie, Vanderstappen; Pauwels, Nelle; Matthys, Christophe; Vanuytsel, Tim; Carbone, Florencia; Tack, Jan

doi:10.1016/s0016-5085(21)00928-8

Cited by 6 publications

(5 citation statements)

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“…This is the topic of ongoing research, but reassuring is the fact that no major changes emerged in laboratory tests at 8 weeks of treatment and that no short-term or long-term significant weight loss occurred in the diet arm. The latter contrasts with observations of significant decreases in nutritional intake and loss of body weight with the dietitian-administered low FODMAP diet in the literature7–9 and also in our own experience (65.8±2.6 vs 64.7±2.5 kg, p=0.001) 10…”

contrasting

confidence: 95%

Role of the DOMINO diet application for managing IBS in primary care and beyond

Tack

Houte

Carbone

2022

Gut

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contrasting

confidence: 95%

Role of the DOMINO diet application for managing IBS in primary care and beyond

Tack

Houte

Carbone

2022

Gut

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“…This approach, termed bottom-up or FODMAP gentle, restricts only 1 or 2 FODMAP subgroups initially, evaluating symptom response and continuing to restrict further only if required ( 37 ). Emerging data suggest that fructans, mannitol, and galacto-oligosaccharides are reportedly the most consistent FODMAP subgroup to trigger symptoms ( 42 , 43 ), and lactose may be helpful to restrict in genetically susceptible individuals, although this remains controversial ( 41 ); hence, these may be most relevant to restrict initially (Figure 3 ). While only limited data exist for this approach, it may be best suited for those with milder symptoms, nutritional deficiencies, or at risk of disordered eating.…”

Section: The Lfdmentioning

confidence: 99%

The Role of Food in the Treatment of Bowel Disorders: Focus on Irritable Bowel Syndrome and Functional Constipation

2022

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Irritable bowel syndrome (IBS) and functional constipation (FC) are among the most common disorders of gut–brain interaction, affecting millions of individuals worldwide. Most patients with disorders of gut–brain interaction perceive food as a trigger for their gastrointestinal symptoms, and specific dietary manipulations/advice have now been recognized as a cornerstone therapeutic option for IBS and FC. We discuss in detail the 2 most common dietary interventions used for the management of IBS-general dietary advice based on the National Institute for Health and Care Excellence guidelines and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). We summarize the literature around the possible mechanisms of FODMAP-mediated IBS pathophysiology, the current 3-step, top-down approach of administering a low FODMAP diet (LFD) (restriction phase, followed by reintroduction and personalization), the efficacy data of its restriction and personalization phases, and possible biomarkers for response to an LFD. We also summarize the limitations and challenges of an LFD along with the alternative approach to administering an LFD (e.g., bottom-up). Finally, we discuss the available efficacy data for fiber, other dietary interventions (e.g., Mediterranean diet, gluten-free diet, and holistic dietary interventions), and functional foods (e.g., kiwifruit, rhubarb, aloe, and prunes) in the management of IBS and FC.

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“…There are many major advantages of feeding trials including high adherence and the ability to design a bespoke placebo diet; however, feeding trials have several disadvantages (Figure 1). They are expensive, and external validity can be limited due to the inherent absence of challenges that FODMAPs in IBS (10,11) Gluten in IBS (12) FODMAP, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; IBS, Irritable Bowel Syndrome.…”

Section: Modes Of Delivery Of Dietary Interventionmentioning

confidence: 99%

Optimal Design of Clinical Trials of Dietary Interventions in Disorders of Gut-Brain Interaction

et al. 2022

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There is accumulating evidence for the fundamental role of diet in the integrated care of disorders of gut-brain interaction. Food is a complex mixture of components with individual, synergistic, and antagonistic effects, compared with the relative purity of a pharmaceutical. Food is also an inherent part of individuals' daily lives, and food choice is strongly tied to food preferences, personal beliefs, cultural and religious practices, and economic status, which can influence its ability to function as a therapeutic intervention. Hence, randomized controlled trials of dietary interventions carry unique methodological complexities that are not applicable to pharmaceutical trials that if disregarded can pose significant risk to trial quality. The challenges of designing and delivering the dietary intervention depend on the type of intervention (i.e., nutrient vs food supplementation or whole-diet intervention). Furthermore, there are multiple modes of delivery of dietary interventions, each with their own advantages (e.g., the high precision of feeding trials and the strong clinical applicability of dietary counseling trials). Randomized placebo-controlled trials of dietary interventions are possible with sufficient attention to their design and methodological nuances. Collaboration with experts in nutrition and dietetics is essential for the planning phase; however, even with expert input, not all challenges can be overcome. Researchers undertaking future dietary trials must be transparent in reporting these challenges and approaches for overcoming them. This review aims to provide guiding principles and recommendations for addressing these challenges to facilitate the conduct and reporting of high-quality trials that inform and improve clinical practice.

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381 Efficacy of a New Approach to the Reintroduction Phase of the Low-Fodmap Diet in Ibs

Cited by 6 publications

References 0 publications

Role of the DOMINO diet application for managing IBS in primary care and beyond

Role of the DOMINO diet application for managing IBS in primary care and beyond

The Role of Food in the Treatment of Bowel Disorders: Focus on Irritable Bowel Syndrome and Functional Constipation

Optimal Design of Clinical Trials of Dietary Interventions in Disorders of Gut-Brain Interaction

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