Low FODMAP Diet in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

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Journal Article
Nutrition, 2017
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Schumann 2017 Low FODMAP Diet in the Treatment of Irritable Bowel Syndrome SR MA.pdfAccepted Manuscript Version1.47 MB
The aim of this review was to systematically assess and meta-analyze the effects of low FODMAP diet (LFD) on severity of symptoms, quality of life and safety in patients with irritable bowel syndrome (IBS). The databases MEDLINE/PubMed, Scopus and the Cochrane Library were screened through 19th January 2016. Randomized controlled trials (RCTs) comparing LFD to other diets were included when assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression and effect on gut microbiota were defined as secondary outcomes. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD to habitual diet, two RCTs provided all meals and compared LFD to western diet, one RCT each compared LFD to a diet high in FODMAPs or a sham diet and two RCTs to other diet recommendations for IBS. Meta-analysis revealed significant group differences for LFD compared to other diets on gastrointestinal symptoms (SMD=-0.62; 95%CI=-0.93 to -0.31; p=0.0001), abdominal pain (SMD=-0.50; 95%CI=-0.77 to -0.22; p=0.008) and on health-related quality of life (SMD=0.36; 95%CI=0.10 to 0.62; p=0.007). Three studies reported a significant reduction in luminal Bifidobacteria after LFD. Adverse events were assessed in three RCTs only, no intervention-related adverse events were reported.
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