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World J Gastroenterol. 2018 Mar 21;24(11):1259-1268. doi: 10.3748/wjg.v24.i11.1259.

Low-FODMAP vs regular rye bread in irritable bowel syndrome: Randomized SmartPill® study.

Author information

1
Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki FI-00790, Finland.
2
Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, Helsinki FI-00290, Finland.
3
Fazer Group/ Fazer Bakeries Ltd, Vantaa FI-01230, Finland.
4
Clinic of Gastroenterology, University of Helsinki and Helsinki University, Hospital Jorvi, Espoo FI-02740, Finland.
5
Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Turku FI-20014, Finland.

Abstract

AIM:

To compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill®.

METHODS:

Our aim was to evaluate if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, different transit times, and fewer IBS symptoms than regular rye bread. The study was a randomized, double-blind, controlled cross-over meal study. Female IBS patients (n = 7) ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day. Intraluminal pH, transit time, and pressure were measured by SmartPill, an indigestible motility capsule.

RESULTS:

Hydrogen excretion (a marker of colonic fermentation) expressed as area under the curve (AUC)(0-630 min) was [median (range)] 6300 (1785-10800) ppm∙min for low-FODMAP rye bread and 10 635 (4215-13080) ppm∙min for regular bread (P = 0.028). Mean scores of gastrointestinal symptoms showed no statistically significant differences but suggested less flatulence after low-FODMAP bread consumption (P = 0.063). Intraluminal pressure correlated significantly with total symptom score after regular rye bread (ρ = 0.786, P = 0.036) and nearly significantly after low-FODMAP bread consumption (ρ = 0.75, P = 0.052). We found no differences in pH, pressure, or transit times between the breads. Gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only during one measurement (out of 14 measurements in total) and therefore did not follow on par with the rye bread bolus.

CONCLUSION:

Low-FODMAP rye bread reduced colonic fermentation vs regular rye bread. No difference was found in median values of intraluminal conditions of the gastrointestinal tract.

KEYWORDS:

Colonic pressure; FODMAP; Irritable bowel syndrome; Rye; Symptom severity; Wireless motility capsule

PMID:
29568206
PMCID:
PMC5859228
DOI:
10.3748/wjg.v24.i11.1259
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Conflict-of-interest statement: Laatikainen R has written a Finnish book on irritable bowel syndrome and diet; He is also founder and owner of Booston Ltd, which provides IBS-related dietetic services to IBS patients, healthcare professionals, and various organizations; Pirkola L, Hongisto SM, and Loponen J are employees of Fazer Bakeries; At the time of the research, Pirkola L was working at the University of Helsinki; Others have no personal interests to declare; Fazer Bakeries funded the study and provided the breads.

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