Division of GI Services, GI Physiology Unit, University College London Hospital, London, UK.
Nutrition & Dietetics Department, University College London Hospital, London, UK.
J Hum Nutr Diet. 2022 Jun;35(3):425-434. doi: 10.1111/jhn.12951. Epub 2021 Oct 27.
The low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet is an effective dietitian-led treatment for irritable bowel syndrome (IBS). An increasing demand of IBS patient referrals has warranted group FODMAP education led by specialist dietitians. Psychological co-morbidities are common in IBS, although how the low FODMAP diet influences psychological outcomes is not understood. The present study aimed to evaluate symptom related outcomes of the diet following group education and assess its effect on psychological profiles.
An observational, prospective study was conducted in 55 IBS patients who attended FODMAP Restriction and FODMAP Reintroduction group sessions. Data were collected at baseline and follow-up after FODMAP Restriction and analysed using descriptive and McNemar's tests. Primary outcome was evaluated by IBS Symptom Severity Score (IBS-SSS). Secondary psychological outcomes included anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and risk of eating disorder questionnaire (SCOFF).
After FODMAP Restriction, 27 of 55 (54%) patients reported clinically relevant symptom improvement, as defined by a reduction in the IBS-SSS ≥50 points, whereas no differences were recorded in the proportion of patients identified with clinical anxiety (p = 1.000) or clinical depression (p = 0.375). Positively, no increased risk of an eating disorder was observed.
The present study provides data supporting the efficacy of the low FODMAP diet in IBS patients who attended dietitian led group education settings in tertiary care. Clinically significant improvements in gastrointestinal symptoms were observed, although with no impact on clinical levels of anxiety, depression or the risk of an eating disorder.
低发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食是一种有效的营养师主导的治疗肠易激综合征（IBS）的方法。由于越来越多的 IBS 患者需要转诊，因此需要由专科营养师来领导 FODMAP 组教育。尽管低 FODMAP 饮食如何影响心理结果尚不清楚，但 IBS 患者常伴有心理共病。本研究旨在评估小组教育后饮食对相关症状的影响，并评估其对心理状况的影响。
对 55 名参加 FODMAP 限制和 FODMAP 再引入小组课程的 IBS 患者进行了一项观察性、前瞻性研究。在 FODMAP 限制和 FODMAP 再引入前后收集数据，并使用描述性和 McNemar 检验进行分析。主要结局评估采用 IBS 症状严重程度评分（IBS-SSS）。次要心理结局包括使用医院焦虑抑郁量表（HADS）评估的焦虑和抑郁，以及饮食障碍风险问卷（SCOFF）评估的风险。
在 FODMAP 限制后，55 名患者中有 27 名（54%）报告了临床相关症状改善，定义为 IBS-SSS 降低≥50 分，而在有临床焦虑（p=1.000）或临床抑郁（p=0.375）的患者比例方面没有差异。令人欣慰的是，没有观察到饮食障碍风险增加。
本研究为参加三级保健专科营养师主导的小组教育环境的 IBS 患者提供了支持低 FODMAP 饮食疗效的数据。观察到胃肠道症状有显著改善，但对临床焦虑、抑郁或饮食障碍风险没有影响。
