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Nutrients. 2018 Aug 4;10(8). pii: E1023. doi: 10.3390/nu10081023.

A Low FODMAP Gluten-Free Diet Improves Functional Gastrointestinal Disorders and Overall Mental Health of Celiac Disease Patients: A Randomized Controlled Trial.

Author information

1
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. leda.roncoroni@unimi.it.
2
Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20100 Milan, Italy. leda.roncoroni@unimi.it.
3
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. kbascunan@med.uchile.cl.
4
Department of Nutrition, University of Chile, 8380453 Santiago, Chile. kbascunan@med.uchile.cl.
5
Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20100 Milan, Italy. luisa.doneda@unimi.it.
6
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. scricciolo.alice@gmail.com.
7
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. vicky.l@hotmail.it.
8
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. federica.branchi@gmail.com.
9
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. francesca.ferretti01@gmail.com.
10
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy. bernardo.dellosso@unimi.it.
11
Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA 94305-5723, USA. bernardo.dellosso@unimi.it.
12
CRC "Aldo Ravelli" for Neuro-technology & Experimental Brain Therapeutics, University of Milan, 20100 Milan, Italy. bernardo.dellosso@unimi.it.
13
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. montanari.valeria8@gmail.com.
14
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. mariateresa.bardella@yahoo.com.
15
Centre for the Prevention and Diagnosis of Celiac Disease/Division of Gastroenterology and Endoscopy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. luca.elli@policlinico.mi.it.

Abstract

A subset of patients with celiac disease (CD) on a gluten-free diet (GFD) reported the persistence of functional gastrointestinal disorders. Foods containing fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) can trigger a broad range of gastrointestinal symptoms in sensitive individuals. We evaluated the effects of a low FODMAP diet (LFD) on gastrointestinal and psychological symptomatology in CD patients. A total of 50 celiac patients on GFDs and with persistence of gastrointestinal symptoms were included. The patients were randomly allocated to one of two dietary groups-one on a low FODMAP GFD (LF-GFD, n = 25) and the other on a regular GFD (R-GFD, n = 25)-for 21 days. Psychological symptomatology and quality of life were evaluated by the Symptom Checklist-90-R (SCL-90) and the Short Form (36) Health Survey (SF-36) questionnaires, respectively. Gastrointestinal symptomatology and general well-being were evaluated by visual analogue scale (VAS) scores. After 21 days, 21 and 23 patients completed the dietary treatment on LF-GFD and R-GFD, respectively. A reduced global SCL-90 index (p < 0.0003) was found in the LF-GFD group but not in the R-GFD one. However, the SF-36 scores did not differ between groups after treatment. The VAS for abdominal pain was much lower, and the VAS for fecal consistency enhanced after treatment in the LF-GFD group. General well-being increased in both groups but with a much higher improvement in the LF-GFD (p = 0.03). A short-term LFD regimen helps to improve the psychological health and gastrointestinal symptomatology with enhanced well-being of CD patients with persisting functional gastrointestinal symptomatology. The long-term clinical effects of LFD in particular subgroups of CD patients need further evaluation.

KEYWORDS:

gastrointestinal symptoms; gluten-free diet; quality of life

PMID:
30081576
PMCID:
PMC6115770
DOI:
10.3390/nu10081023
[Indexed for MEDLINE]
Free PMC Article

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