D0262 - The Low FODMAP Diet Improves Abdominal and Overall Symptoms in Patients With All Subtypes of Irritable Bowel Syndrome

Tuesday, October 25, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Gregory Dean, MD

University of Michigan Health System
Ann Arbor, MI

Gregory Dean, MD¹, Samuel W. Chey, MPH¹, William D. Chey, MD²
¹University of Michigan Health System, Ann Arbor, MI; ²Michigan Medicine, Ann Arbor, MI

Introduction: There is substantial evidence that a diet low in fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) improves symptoms in patients with Irritable Bowel Syndrome and diarrhea (IBS-D). Though the low-FODMAP diet is increasingly used in patients with IBS and constipation (IBS-C) or mixed bowel habits (IBS-M), there is little data to support this practice. We aim to compare the real-world effectiveness of a low-FODMAP diet in patients with IBS-D, IBS-C, and IBS-M.

Methods: Utilizing a commercially available meal procurement service which prepares and delivers meals certified low in FODMAP content (Modify Health, Atlanta, GA), patients with suspected IBS met with a registered dietitian and completed the IBS symptom severity scale (IBS-SSS) questionnaire before starting the low-FODMAP diet and after the restriction phase of the diet plan. A decrease in IBS-SSS score of >100 was defined as a responder.

Results: 403 IBS patients filled out baseline and post-elimination IBS-SSS surveys. 26% of patients were referred by a GI specialist; the rest were self-referrals. 193 (48%) patients had severe IBS (IBS-SSS > 300) prior to the intervention. IBS-D patients had a 71% improvement in pain, 56% improvement in bloating, and 55% improvement in bowel movement satisfaction. 77% of IBS-D patients had improvement in total IBS-SSS >100. IBS-C patients had a 69% improvement in pain, 49% improvement in bloating, and 42% improvement in bowel movement satisfaction. 67% of IBS-C patients had improvements in IBS-SSS >100. IBS-M patients had 85% improvement in pain, 55% improvement in bloating, and 53% improvement in bowel movement satisfaction. 72% of IBS-M patients had improvement in total IBS-SSS >100. Those who used the commercial meals for "all" of the restriction phase had a mean IBS-SSS improvement of 174, and mean quality of life (QOL) improvement of 40%, while those who used the commercial meals for "some" of the elimination phase had mean IBS-SSS improvement of 153, and mean QOL improvement of 33% (p=0.059 and 0.03, respectively).

Discussion: This data supports the effectiveness of a low-FODMAP diet for all IBS subtypes, including IBS-C and IBS-M. Patients who obtained prepared low-FODMAP meals during the entire restriction phase experienced greater benefits than those who only obtained meals for a portion of the restriction phase.

IBS Subtype	Total Number of Patients	IBS-SSS (Mean % Improvement)	Pain (Mean % Improvement)	Bloating (Mean % Improvement)	BM Satisfaction (Mean % Improvement)	% Improvement in IBS-SSS >100
IBS-D	87	59 (p< 0.001)	72	56	56	77
IBS-C	73	50 (p< 0.001)	70	49	42	67
IBS-M	91	56 (p< 0.001)	73	55	53	73

Table: Table 1. Improvement in IBS-SSS Categories by IBS-Subtype

Disclosures:

Gregory Dean indicated no relevant financial relationships.

Samuel Chey indicated no relevant financial relationships.

William Chey: Abbvie – Consultant. Allakos – Consultant. Alnylam – Consultant. Arena – Consultant. Biomerica – Consultant. Commonwealth Diagnostics International – Consultant. Gemelli – Consultant. GI OnDEMAND – Stock Options. Ironwood – Consultant. Isothrive – Consultant. Isothrive – Stock Options. Modify Health – Stock Options. Nestle – Consultant. Phathom – Consultant. Progenity – Consultant. QOL Medical – Consultant, Grant/Research Support. Redhill – Consultant. Salix – Consultant, Grant/Research Support. Urovant – Consultant. Vibrant – Consultant.

Gregory Dean, MD¹, Samuel W. Chey, MPH¹, William D. Chey, MD². D0262 - The Low FODMAP Diet Improves Abdominal and Overall Symptoms in Patients With All Subtypes of Irritable Bowel Syndrome, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.