Long‐term impact of the low‐FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome
Open accessAbstract
Background: The low‐FODMAP diet is a frequently used treatment for irritable bowel syndrome (IBS). Most research has focused on short‐term FODMAP restriction; however, guidelines recommend that high‐FODMAP foods are reintroduced to individual tolerance. This study aimed to assess the long‐term effectiveness of the low‐FODMAP diet following FODMAP reintroduction in IBS patients. Methods: Patients with IBS were prospectively recruited to a questionnaire study following completion of dietitian‐led low‐FODMAP education. At baseline and following FODMAP restriction (short term) only, gastrointestinal symptoms were measured as part of routine clinical care. Following FODMAP reintroduction, (long term), symptoms, dietary intake, acceptability, food‐related quality of life (QOL), and healthcare utilization were assessed. Data were reported for patients who continued long‐term FODMAP restriction (adapted FODMAP) and/or returned to a habitual diet (habitual). Key Results: Of 103 patients, satisfactory relief of symptoms was reported in 12% at baseline, 61% at short‐term follow‐up, and 57% at long‐term follow‐up. At long‐term follow‐up, 84 (82%) patients continued an ‘adapted FODMAP’ diet (total FODMAP intake mean 20.6, SD 14.9 g/d) compared with 19 (18%) of patients following a ‘habitual’ diet (29.4, SD 22.9 g/d, P=.039). Nutritional adequacy was not compromised for either group. The ‘adapted FODMAP’ group reported the diet cost significantly more than the ‘habitual’ group (P<.001) and affected social eating (P<.01) but there was no effect on food‐related QOL. Healthcare utilization was similar between both groups. Conclusion and Inferences: Low‐FODMAP education is effective for long‐term IBS management, enables a nutritionally adequate diet, and is broadly acceptable to patients.
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The effect of FODMAP reintroduction to tolerance on IBS symptoms is unclear.
“The effect of FODMAP reintroduction to tolerance on IBS symptoms is therefore unclear, although there have been open-label studies reporting the long-term efficacy of an adapted low FODMAP diet ranges somewhere between 50% and 60%.177 203”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [203]
Open-label studies report the long-term efficacy of an adapted low FODMAP diet ranges somewhere between 50% and 60%.
“The effect of FODMAP reintroduction to tolerance on IBS symptoms is therefore unclear, although there have been open-label studies reporting the long-term efficacy of an adapted low FODMAP diet ranges somewhere between 50% and 60%.177 203”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [203]
Cites
Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis
Lovell, R. M., & Ford, A. C. (2012) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2012.02.029 · Cited by 2,155 · see citing works
The impact of irritable bowel syndrome on health-related quality of life
Gralnek, I. M., Hays, R. D., Kilbourne, A., Naliboff, B., & Mayer, E. A. (2000) · Gastroenterology · doi:10.1053/gast.2000.16484 · Cited by 781 · see citing works
Böhn, L., Störsrud, S., Törnblom, H., Bengtsson, U., & Simrén, M. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.105 · Cited by 655 · see citing works
Design of Treatment Trials for Functional Gastrointestinal Disorders
Irvine, E. J., Tack, J., Crowell, M. D., Gwee, K. A., Ke, M., Schmulson, M. J., Whitehead, W. E., & Spiegel, B. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.02.010 · Cited by 550 · cited 1× · see citing works
“643 My life in relation to food and meals is close to my ideala 9 (45) 5 (25) 6 (30) 25 (29) 27 (32) 32 (38) .”
Food-Related gastrointestinal symptoms in the irritable bowel syndrome
Simrén, M., Månsson, A., Langkilde, A. M., Svedlund, J., Abrahamsson, H., Bengtsson, U., & Björnsson, E. S. (2001) · Digestion · doi:10.1159/000051878 · Cited by 529 · see citing works
Blake, M. R., Raker, J. M., & Whelan, K. (2016) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13746 · Cited by 495 · see citing works
Self-citationShepherd, S. J., & Gibson, P. R. (2006) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2006.07.010 · Cited by 408 · see citing works
An irritable bowel syndrome-specific symptom questionnaire: development and validation
K., W. I., S., F., J., H. C., H., J. R., F., L. G., A., M. E., A., P. R., K., W. I., & J., N. (2003) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520310004209 · Cited by 324 · see citing works
Design of Treatment Trials for Functional Gastrointestinal Disorders
Irvine, E. J., Whitehead, W. E., Chey, W. D., Matsueda, K., Shaw, M., Talley, N. J., & Veldhuyzen van Zanten, S. J. O. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.058 · Cited by 286 · see citing works
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Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31548-8 · Cited by 818 · see citing works
British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., et al. (2021) · Gut · doi:10.1136/gutjnl-2021-324598 · Cited by 547 · see citing works
Hammer, H. F., Fox, M. R., Keller, J., Salvatore, S., Basilisco, G., Hammer, J., Lopetuso, L., Benninga, M., Borrelli, O., Dumitrascu, D., et al. (2022) · United European Gastroenterology Journal · doi:10.1002/ueg2.12133 · Cited by 189 · see citing works
Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome
Chey, W. D., Keefer, L., Whelan, K., & Gibson, P. R. (2021) · Gastroenterology · doi:10.1053/j.gastro.2020.06.099 · Cited by 154 · see citing works
Self-citationImpact of diet on symptoms of the irritable bowel syndrome
Spiller, R. (2021) · Nutrients · doi:10.3390/nu13020575 · Cited by 86 · see citing works
The role of diet in irritable bowel syndrome: implications for dietary advice
Rej, A., Aziz, I., Tornblom, H., Sanders, D. S., & Simrén, M. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12966 · Cited by 61 · see citing works
Optimal Design of Clinical Trials of Dietary Interventions in Disorders of Gut-Brain Interaction
Staudacher, H. M., Yao, C. K., Chey, W. D., & Whelan, K. (2022) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001732 · Cited by 52 · see citing works
Self-citationFragkos, K. C., Keetarut, K., Cox, A., Eady, J., Emmanuel, A. V., & Zarate-Lopez, N. (2019) · Gastroenterology Research · doi:10.14740/gr1133 · Cited by 11 · see citing works
- Authors
- O'Keeffe, M., Jansen, C., Martin, L., Williams, M., Seamark, L., Staudacher, H. M., Irving, P. M., Whelan, K., & Lomer, M. C.
- Affiliations
- King's College London (GB)
- Somerset Partnership NHS Foundation Trust (GB)
- Corresponding author
- Lomer, M. C.
- Venue
- Neurogastroenterology & Motility
- Publisher
- Wiley
- Published
- 2017-07-14
- Volume
- 30
- Issue
- 1
- ISSN
- 1350-1925 (ISSN-L)
- 1365-2982
- OpenAlex
- W2735433740
- Cited by
- 181
- References
- 9
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 10 · 2023: 17 · 2022: 27 · 2021: 26 · 2020: 27 · 2019: 31 · 2018: 17 · 2017: 2
- FWCI
- 22.12
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Neurogastroenterology & Motility (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- low FODMAP diet, irritable bowel syndrome, long-term dietary adherence, gastrointestinal symptoms, dietary intake, diet acceptability, food-related quality of life, health care utilization, diet cost, nutritional adequacy
- MeSH terms
- Fermented Foods, Adult, Delivery of Health Care, Eating, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Treatment Outcome, Patient Satisfaction, Irritable Bowel Syndrome
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