Low FODMAP diet in Egyptian patients with Crohn's disease in remission phase with functional gastrointestinal symptoms

Elhusseiny, M.H.; Amine, Amira; Salem, Osama; Tayel, Dalia I.; Elsayed, Eman A

doi:10.1002/jgh3.12037

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…This result contradicts Egypt's report that LFD significantly improved IBS symptoms in quiescent CD. 2 In the CD patients in that report, as in the Cox et al study, many patients had small bowel lesions. Egypt's study did not show the exact amount of lactose, but lactose was almost zero based on a 7-day dietary sample.…”

Section: Why a Low Fodmap Diet Wasmentioning

confidence: 75%

Why a Low FODMAP Diet Was Ineffective for IBS Symptoms in Quiescent Crohn's Disease

Uno¹

2020

Gastroenterology

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Section: Why a Low Fodmap Diet Wasmentioning

confidence: 75%

Why a Low FODMAP Diet Was Ineffective for IBS Symptoms in Quiescent Crohn's Disease

Uno¹

2020

Gastroenterology

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“…The use of biologics were only discussed in 26 of the 216 studies, and were not mentioned in any studies from sub-Saharan Africa or East Asia and Pacific (see ). Nutritional therapy was also scaresly mentioned, with only six studies discussing dietary changes as a treatment for IBD: four from India[ 41 - 44 ], one from Egypt[ 45 ], and one from Malawi[ 46 ] (see ).…”

Section: Resultsmentioning

confidence: 99%

Crohn’s disease in low and lower-middle income countries: A scoping review

Rajbhandari¹,

Blakemore²,

Gupta³

et al. 2020

WJG

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BACKGROUND While Crohn’s disease has been studied extensively in high-income countries, its epidemiology and care in low and lower-middle income countries (LLMICs) is not well established due to a lack of disease registries and diagnostic capacity. AIM To describe the published burden, diagnostic/treatment capacity, service utilization, challenges/barriers to individuals with Crohn’s in LLMICs and their providers. METHODS We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed, Embase and World Health Organization Global Index Medicus. Two independent reviewers screened the titles and abstracts of all of the publications found in this search, reviewed selected publications, and extracted relevant data, which underwent descriptive review and was analyzed in Excel. RESULTS The database search yielded 4486 publications, 216 of which were determined to be relevant to the research questions. Of all 79 LLMICs, only 21 (26.6%) have publications describing individuals with Crohn’s. Overall, the highest number of studies came from India, followed by Tunisia, and Egypt. The mean number of Crohn’s patients reported per study is 57.84 and the median is 22, with a wide range from one to 980. CONCLUSION This scoping review has shown that, although there is a severe lack of population-based data about Crohn’s in LLMICs, there is a signal of Crohn’s in these settings around the world.

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“…In the LFD group, in particular, available dietary choices were restricted to a great degree, reducing long-term adherence ( 20 , 33 ). Ooi et al ( 50 ) and Halmos ( 51 ) noted that extensive or inappropriate use of the LFD could have a negative impact on the health of patients. On the other hand, the duration of most LFD trials was limited (<8 weeks) and could not ensure long-term efficacy comparable to the drug trials ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

A Low-FODMAP Diet Improves the Global Symptoms and Bowel Habits of Adult IBS Patients: A Systematic Review and Meta-Analysis

et al. 2021

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Background: A low-fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet has been reported to be associated with improving the symptoms of irritable bowel syndrome (IBS); however, its efficacy as evaluated by different studies remains controversial.Objective: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to explore the efficacy of a low-FODMAP diet (LFD) in alleviating the symptoms of IBS.Methods: A search of the literature for RCTs that assessed the efficacy of an LFD in treating IBS patients was conducted using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. The searches in each database were conducted from the inception of the database to February 2021. Two independent reviewers screened citations and a third reviewer resolved disagreements. Two independent reviewers also performed eligibility assessments and data extraction. The RCTs that evaluated LFDs vs. a normal IBS or usual diet and assessed changes of IBS symptoms were included in the search. Data were synthesized as the relative risk of global symptoms improvement, mean difference of IBS Severity Scoring System (IBS-SSS) score, sub-items of IBS-SSS irritable bowel syndrome-related quality of life (IBS-QOL), hospital anxiety and depression scale (HADS), stool consistency/frequency, and body mass index (BMI) using a random effects model. The risk of bias was assessed using Risk of Bias Tool 2 (RoB 2). The bias of publication was assessed based on Egger's regression analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.Results: A total of 2,768 citations were identified. After full-text screening, a total of 10 studies were eligible for the systematic review and were subsequently used to compare an LFD with various control interventions in 511 participants. An LFD was associated with the improvement of global symptoms [n = 420; Risk Ratio (RR) = 1.54; 95% Confidence Interval (CI) 1.18 to 2; I2 = 38%], improvement of stool consistency [n = 434; Mean difference (MD) = −0.25; 95% CI −0.44 to −0.06; I2= 19%), and a reduction trend of stool frequency (n = 434; MD = −0.28; 95% CI −0.57 to 0.01; I2 = 68%) compared with control interventions. There was no statistically significant change in IBS-QOL (n = 484; MD = 2.77; 95% CI −2 to 7.55; I2 = 62%), anxiety score (n = 150; MD = −0.45; 95% CI −3.38 to 2.49; I2 = 86%), depression score (n = 150; MD = −0.05; 95% CI −2.5 to 2.4; I2 = 88%), and BMI (n = 110; MD = −0.22; 95% CI −1.89 to 1.45; I2 = 14%). The overall quality of the data was “moderate” for “global improvement of IBS symptom,” “stool consistency,” “stool consistency for IBS with diarrhea (IBS-D),” and “stool frequency for IBS-D,” and “low” or “very low” for other outcomes according to GRADE criteria.Conclusion: An LFD is effective in reducing the global symptoms and improving the bowel habits of adult IBS patients. The efficacy for IBS-D patients can also be more pronounced.Systematic Review Registration: CRD42021235843.

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Low FODMAP diet in Egyptian patients with Crohn's disease in remission phase with functional gastrointestinal symptoms

Cited by 11 publications

References 25 publications

Why a Low FODMAP Diet Was Ineffective for IBS Symptoms in Quiescent Crohn's Disease

Why a Low FODMAP Diet Was Ineffective for IBS Symptoms in Quiescent Crohn's Disease

Crohn’s disease in low and lower-middle income countries: A scoping review

A Low-FODMAP Diet Improves the Global Symptoms and Bowel Habits of Adult IBS Patients: A Systematic Review and Meta-Analysis

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