Low FODMAP diet in children and adolescents with functional bowel disorder: A clinical case note review

Abstract

Background and Aims Functional bowel disorders (FBD), such as irritable bowel syndrome (IBS), are increasingly more common in children and affect up to 20% of children. The etiology is multifactorial with no clear organic cause. Symptoms are recurrent and are associated with a reduced quality of life, school absences, and psychological challenges. Treatment options are variable. FODMAPs are short‐chained carbohydrates, poorly absorbed by the gastrointestinal tract due to their increased osmotic activity and excess gas production from the bacterial fermentation process. There is a paucity of data examining dietary interventions that restrict carbohydrates in children with IBS. The aim of this study was to examine the use of the low FODMAP diet (LFD) in children with an FBD. Methods A retrospective clinical case note review of children with an FBD managed with an LFD was undertaken. Anthropometry and clinical data were collected by a pediatric gastroenterology dietitian. An IBS satisfaction survey was used to assess diet outcomes. Statistical analyses were completed using Excel. Results Of the 29 children included in this study, complete resolution of gastrointestinal symptoms was observed for 11 of 12 (92%) of those with bloating, 13 of 15 (87%) of those with diarrhea, and 17 of 22 (77%) of those with abdominal pain. Twenty‐three (79%) participants reported an improvement of symptoms. Fructans were the most common symptom‐causing carbohydrate. Conclusion The LFD is a useful dietary treatment strategy for children with FBD. This study adds to the small body of evidence supporting FODMAP dietary interventions in children with FBD. Further prospective studies are required.

Parental Opinion about the Low FODMAP Diet in Dietary Treatment of Children with Functional Abdominal Pain

“…The intervention was based on recommendations provided by a dietitian through dietary consultations and a self-catered diet. In contrary to our findings, most children defined the diet as easy to follow [21]. Perhaps the reason was the older age of the children, which may affect the lifestyle, perception of following the diet, or food choices.…”

“…In addition, more than a third of respondents in this group disagreed with this statement, considering the diet as difficult. There are only a few studies which examined the opinion and satisfaction of the diet among patients [4,20], and only one in children [21]. In the latter study, children (4-17 years) followed the low FODMAP diet for four weeks.…”

Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine

“…92 Some studies have shown an improvement in the severity and the frequency of pain in pediatric patients under fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) exclusive-regime. 93 In addition, the role of food on their symptoms is often expressed by IBS patients, whether they are adults or children. 94 The role of personal beliefs and psychological factors is proven to impact the severity of symptoms.…”

What Are the Pearls and Pitfalls of the Dietary Management for Chronic Diarrhoea?

“…Numerous observational, randomised control trials [ 24 , 25 , 26 , 27 , 28 , 29 , 30 ] and meta-analyses [ 31 , 32 , 33 , 34 ] support the efficacy of a low FODMAP diet to treat adults with IBS. Prospective and observation studies across all age groups have also been conducted [ 35 , 36 ]. The low FODMAP diet is a short-term restrictive diet; the reintroduction and long-term dietary management are important to ensure diet diversity [ 37 ].…”

“…Dietitians are the experts on the nutritional management of conditions where food plays a role, including chronic diarrhoea. As seen with the low FODMAP diet, dietitians also have an important role in research [ 23 , 25 , 26 , 29 , 35 , 36 , 73 , 134 ] and the development of evidence-based practice [ 16 ]. Thus, the role of the dietitian is multifactorial and extends beyond one-on-one nutrition counselling.…”