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Clin Nutr. 2018 Feb;37(1):123-129. doi: 10.1016/j.clnu.2017.05.019. Epub 2017 May 24.

Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review.

Author information

1
Innovation and Excellence Class of Preventive Medicine, Grade 2013, School of Public Health, Southern Medical University, Guangzhou 510515, China.
2
School of Mathematics, Sun Yat-sen University, Guangzhou 510275, China.
3
Department of Gastroenterology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou 510080, China. Electronic address: shixuedai@hotmail.com.

Abstract

BACKGROUND & AIMS:

To assess the current evidence regarding the benefit of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol (FODMAP) diet in the treatment of patients with inflammatory bowel disease (IBD).

METHODS:

Databases such as PubMed, Web of Science, Medline were comprehensively searched for relevant studies through January 2017. The pooled odds ratio (OR) and weighted mean difference (WMD) with 95% confidence intervals (CIs) were used to analyze the dichotomous variables (diarrhea response, abdominal pain and bloating, etc.) and the continuous variables. Random- and fixed-effects models were chosen according to heterogeneity.

RESULTS:

Two RCTs and four before-after studies with a total of 319 patients (96% in remission) were identified. Except for the constipation response, there was a significant improvement in other symptoms: diarrhea response (OR: 0.24, 95% CI: 0.11-0.52, p = 0.0003), satisfaction with gut symptoms (OR: 26.84, 95% CI: 4.6-156.54, p < 0.00001), abdominal bloating (OR: 0.10, 95% CI: 0.06-0.16, p < 0.00001), abdominal pain (OR: 0.24, 95% CI: 0.16-0.35, p < 0.00001), fatigue (OR: 0.40, 95% CI: 0.24-0.66, p = 0.0003) and nausea (OR: 0.51, 95% CI: 0.31-0.85, p = 0.009).

CONCLUSIONS:

The present meta-analysis offers proof to support that a low FODMAP diet is beneficial for reducing gastrointestinal symptoms in patients with quiescent IBD. With the inherent limitations, the findings of this analysis remain to be confirmed and updated by further high-volume, well-designed and long-term follow-up studies.

KEYWORDS:

FODMAP diet; Gastrointestinal symptoms; IBD; Meta-analysis

PMID:
28587774
DOI:
10.1016/j.clnu.2017.05.019

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