University of Nebraska Medical Center Omaha, NE, United States
Bernadette Lamb, MD, Banreet Dhindsa, MD, Harlan Sayles, MS, Emily Glenn, MSLS, Derrick Eichele, MD University of Nebraska Medical Center, Omaha, NE
Introduction: Despite clinical disease remission, inflammatory bowel disease (IBD) patients frequently experience ongoing gastrointestinal symptoms, which can have a significant effect on a patient’s quality of life. Though currently used for irritable bowel syndrome (IBS), in recent years, use of a low-FODMAP diet has expanded to patients with IBD, who continue to experience similar gastrointestinal symptoms despite clinical disease remission. We performed a systematic review and meta-analysis regarding application of low-FODMAP diet in patients with IBD.
Methods: We conducted a comprehensive search of multiple electronic databases for patients over the age of 18 with a prior diagnosis of IBD who engaged in a low-FODMAP diet. The primary outcome was to evaluate overall symptom improvement and secondary outcomes were to evaluate Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) and quality of life measures. Comparisons between groups used restricted maximum likelihood estimation, while estimates of proportions use the method of DerSimonian and Laird after a Freeman-Tukey Double Arcsine Transformation.
Results: Five studies, including 2 randomized controlled trials and 3 observational studies, with 308 patients were included in our analysis. The pooled overall symptom improvement was significant in the low-FODMAP diet group as compared to the control group (pooled log OR (95% CI) = 1.67 (0.89-2.45) p< 0.001). There was a significant decrease in IBS-SSS scores (pooled estimate (95% CI) = -1.55 (-2.10, -1.00, p< 0.001) and a significant increase in SIBDQ, IBD-Q scores (pooled estimate (95% CI) = 0.43 (0.04, 0.83), p=0.03) with use of low FODMAP diet. There was no significant change in the control group post treatment. Low to moderate heterogeneity was noted in our analysis.
Discussion: Overall, our systematic review and meta-analysis supported use of a low-FODMAP diet in IBD patients, as with proper use, it may result if overall improvement in gastrointestinal symptoms and perceived quality of life. Though this diet may require substantial patient education, the low-FODMAP diet may be a beneficial option for those IBD patients who continue to experience bothersome gastrointestinal symptoms despite disease remission.
Banreet Dhindsa indicated no relevant financial relationships.
Harlan Sayles indicated no relevant financial relationships.
Emily Glenn indicated no relevant financial relationships.
Derrick Eichele indicated no relevant financial relationships.
Bernadette Lamb, MD, Banreet Dhindsa, MD, Harlan Sayles, MS, Emily Glenn, MSLS, Derrick Eichele, MD. P2693 - Systematic Review With Meta-Analysis: The Effect of the Low-FODMAP Diet on Gastrointestinal Symptoms and Quality of Life in Inflammatory Bowel Disease, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.