The effect of low FODMAP diet with and without gluten on irritable bowel syndrome: A double blind, placebo controlled randomized clinical trial.
Study Goal
The researchers aimed to determine whether the exacerbation of IBS symptoms from wheat and barley consumption is due to their fructan content or gluten, comparing low-FODMAP diets with and without gluten.
Results Summary
Both gluten and placebo groups showed significant improvements in IBS symptoms and quality of life, with only 5 patients in the gluten group reporting symptom exacerbation, suggesting fructans (not gluten) are the primary trigger.
Population
49 IBS patients
Effective Dosage
5 g/day of gluten powder or rice flour (placebo)
Duration
Not specified in the abstract
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low FODMAP diet with gluten | decrease | total scores of IBS-SSS | IBS patients | -49% | Significant improvements were observed | #1 |
low FODMAP diet with gluten | decrease | abdominal pain intensity | IBS patients | -52% | Significant improvements were observed | #2 |
low FODMAP diet with gluten | decrease | abdominal pain frequency | IBS patients | -46% | Significant improvements were observed | #3 |
low FODMAP diet with gluten | decrease | abdominal distension | IBS patients | -63% | Significant improvements were observed | #4 |
low FODMAP diet with gluten | decrease | Interference with community function | IBS patients | -45% | Significant improvements were observed | #5 |
low FODMAP diet with gluten | increase | quality of life | IBS patients | +32% | Significant improvements were observed | #6 |
low FODMAP diet with placebo (rice flour) | decrease | total scores of IBS-SSS | IBS patients | -32% | Significant improvements were observed | #7 |
low FODMAP diet with placebo (rice flour) | decrease | abdominal pain intensity | IBS patients | -45% | Significant improvements were observed | #8 |
low FODMAP diet with placebo (rice flour) | decrease | abdominal pain frequency | IBS patients | -26% | Significant improvements were observed | #9 |
low FODMAP diet with placebo (rice flour) | decrease | abdominal distension | IBS patients | -29% | Significant improvements were observed | #10 |
low FODMAP diet with placebo (rice flour) | decrease | Interference with community function | IBS patients | -14% | Significant improvements were observed | #11 |
low FODMAP diet with placebo (rice flour) | increase | quality of life | IBS patients | +23% | Significant improvements were observed | #12 |
gluten-containing diet | increase | IBS symptoms | 5 patients | - | reported exacerbation of their symptoms | #13 |
wheat and barley consumption | increase | IBS symptoms | most of the patients | - | Exacerbation of IBS symptoms | #14 |
BACKGROUND & AIM: Although the effects of low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet on amelioration of irritable bowel syndrome (IBS) symptoms have been reported previously, it has not yet been elucidated whether the gluten of wheat and barley induces the symptoms or only their fructans lead to aggravation of the symptoms. The aim of this study was to assess the effect of low FODMAPs diet with vs. without gluten on clinical symptoms in IBS patients. METHODS: In this double-blind, placebo-controlled randomized trial, forty nine IBS patients were randomly assigned to placebo and/or intervention group. Patients in the intervention group received 5 gr/day of gluten powder with low FODMAP diet, while placebo group received 5 gr of rice flour as placebo, with low FODMAP diet. Quality of life (QoL) and IBS-SSS (symptom severity score) were measured before and after the intervention using a valid QoL questionnaire and a standard visual analog scale, respectively. RESULTS: Significant improvements were observed in total scores of IBS-SSS (-32% vs. - 49%), abdominal pain intensity (-45% vs. -52%), and frequency (-26 vs. -46%), abdominal distension (-29% vs. -63%), Interference with community function (-14% vs. -45%) and quality of life (+23 vs. +32%) in both gluten and placebo groups respectively (P < 0.05). Only 5 patients in the gluten-containing diet reported exacerbation of their symptoms. CONCLUSION: Exacerbation of IBS symptoms after wheat and barley consumption is due to their fructan, and not related to their gluten content in most of the patients. CLINICAL TRIAL REGISTRATION NO: IRCT20100524004010N29.