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Page 24
Volume 05
Journal of Clinical Nutrition & Dietetics
ISSN: 2472-1921
JOINT EVENT
June 17-18, 2019 London, UK
Nutrition World 2019
Euro Obesity 2019
June 17-18, 2019
&
26
th
World Nutrition Congress
15
th
Euro Obesity and Endocrinology Congress
Diet in irritable bowel syndrome: can a case-specific diet be an alternative to standardized low FODMAP
diet?
Odila Mezini
1
,Pietro Fusaroli
2
1,2
Hospital of Imola, Italy
I
rritable Bowel Syndrome (IBS) is a functional chronic, relapsing and often life-long disorder. Generally referred
symptoms are abdominal pain or discomfort, change in bowel habits, disordered defaecation (constipation and/
or diarrhoea), abdominal distension and bloating. To date, it is being more and more frequent, with a prevalence
of 10% to 30% in the general population, becoming one of the most common gastrointestinal disorders. Different
strategies have been investigated for IBS management, from pharmacological and nonpharmacological therapies.
Yet, it is generally accepted and demonstrated that diet plays a key role in IBS, becoming the first-line approach
in IBS treatment. Different dietary approaches have been investigated and the most effective seems to be the low
Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) diet; there is a growing
body of evidence supporting its beneficial effects. Yet, since an important proportion of patients with irritable bowel
syndrome associate their symptoms with the ingestion of specific foods and sometimes foods classified ad FODMAP
may not be a trigger, while those not classified as FODMAP may worsen symptoms, a personal susceptibility may
occur. Moreover, as it is a restrictive diet, the low-FODMAP diet may lead to nutritional deficiencies and disordered
eating.Inthis study, we investigated if a case-specific diet, based on personal tolerance versus certain food items,
could be an alternative approach in IBS dietary therapy.
Methodology and Theoretical Orientation:
The present study was performed in the Gastroenterology Unit of
S.Maria della Scaletta Hospital. Patients were recruited from April to September 2018. For patients’ recruitment,
Rome IV criteria were used; questionnaires were performed by the physicians during medical examinations. Those
who fulfilled the criteria were then interviewed to assess the IBS subtype. Questionnaires about food habits and food
frequency, as well as symptoms associated with specific food items consumption were provided. Then, a personalized
14-day diet was elaborated for each patient. Diets provided a total energy according to the patient’s requirements in
order to maintain the initial body weight; the distribution between macronutrients was similar for all diets, following
a typical Mediterranean diet, with 55-60% carbohydrates, 12-18% proteins and 24-32% fat. The amount of fiber
varied from IBS-C and IBS-D. Together with the grams for each ingredient of the diet, advices for cooking methods,
food storage and recipes were provided in order to better monitor the diet adhesion. To assess the effect of diet
on IBS symptom, an IBS-SS was used. The first grade of the severity score was assessed the day before the patients
started the diet, and was then performed again after 1 month of diet.
Findings:
From the 14 patients who participated to the study, 12 reported an improvement of symptoms associated
with IBS. One patient was considered borderline because a diagnosis of gallstones was made during the study but the
results were taken into account, and another patient (IBS-D) started an antibiotic therapy after 1 week of diet, so the
results were not considered. For the IBS-D subtype patients, the elimination of some food items, not all FODMAPs,
decreased IBS-SS from severe to mild in 3 patients, from severe to remission in 2 patients and from moderate to
remission in 2 patients. For IBS-C patients, symptoms showed a slower improvement over time. All 6 IBS-C patients
reported an improvement in stool frequency and stool appearance, but bloating and abdominal distension was still
present in 2 of them with the same intensity as before the diet, while for the remaining 4 the pain or discomfort
perceived was reduced from severe to remission.
Odila Mezini et al., J Clin Nutr Diet 2019, Volume 05