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Efficacy and Safety of a Low-FODMAP Diet in Combination with a Gluten-Free Diet for Adult Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences
November 1, 2024
Jing Zhang et al. (7 authors)
Journal ArticleSystematic ReviewMeta-AnalysisHuman Study
Study Details

Study Goal

The researchers sought to determine whether a low-FODMAP combined gluten-free diet (LF-GFD) improves symptoms and psychological well-being in patients with irritable bowel syndrome (IBS).

Results Summary

The study found that LF-GFD significantly reduced bloating, pain, and IBS symptom severity while improving quality of life and reducing anxiety and depression scores compared to a standard gluten-free diet (GFD).

Population

Patients diagnosed with irritable bowel syndrome (IBS).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
VAS bloating ratings
patients with IBS
RR = -0.58, 95%CI -0.92-0.23, P = 0.0010, I2 = 83%
reduced
#1
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
VAS pain scores
patients with IBS
RR = -0.42, 95%CI -0.66-0.19, P = 0.005, I2 = 58%
reduced
#2
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
IBS-SSS scores
patients with IBS
MD = -1.42, 95%CI -2.74-0.10, P = 0.03, I2 = 24%
substantial enhancement in
#3
low-FODMAP combined gluten-free diet (LF-GFD)
increase
IBS-QoL ratings
patients with IBS
MD = 3.75, 95%CI 0.98-6.53, P = 0.008, I2 = 33%
substantial enhancement in
#4
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
SDS scores
patients with IBS
MD = -2.56, 95%CI -3.38-1.74, P < 0.00001, I2 = 65%
substantial drop in
#5
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
SAS scores
patients with IBS
MD = -4.30, 95%CI -6.53-2.24, P < 0.0001, I2 = 0%
substantial drop in
#6
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
clinical symptoms
individuals diagnosed with irritable bowel syndrome
-
significantly enhances
#7
low-FODMAP combined gluten-free diet (LF-GFD)
decrease
anxiety and depression
individuals diagnosed with irritable bowel syndrome
-
reduces
#8
Abstract

BACKGROUND: Common gastrointestinal disease irritable bowel syndrome (IBS) is marked by symptoms like changed bowel habits, bloating, and stomach ache. A low-FODMAP combined gluten-free diet (LF-GFD) has been suggested as a possible therapy for IBS symptoms management. OBJECTIVE: This study sought to investigate whether a LF-GFD would help patients with IBS. METHODS: Strict inclusion and exclusion criteria from internet databases helped to identify clinical studies evaluating the intervention of LF-GFD in the treatment of IBS patients. Using measurements including the visual analog scale (VAS) for bloating and pain, the IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QoL), the main results evaluated were the efficacy of LF-GFD in reducing IBS symptoms. Furthermore assessed were the psychological impacts of LF-GFD utilizing the self- rating depression scale (SDS) and self- rating anxiety scale (SAS). RESULTS: A total of 437 patients (221 on LF-GFD diet and 216 on GFD) were involved in 4 randomized controlled trials and 4 cohort studies. The combined results indicated that LF-GFD reduced the VAS bloating ratings (RR = - 0.58, 95%CI - 0.92-0.23, P = 0.0010, I2 = 83%) and the VAS pain scores (RR = - 0.42, 95%CI - 0.66-0.19, P = 0.005, I2 = 58%). In addition, LF-GFD indicated a substantial enhancement in IBS-SSS scores (MD = - 1.42, 95%CI - 2.74-0.10, P = 0.03, I2 = 24%) and IBS-QoL ratings (MD = 3.75, 95%CI 0.98-6.53, P = 0.008, I2 = 33%). Moreover, the LF-GFD group showed a substantial drop in SDS (MD = - 2.56, 95%CI - 3.38-1.74, P < 0.00001, I2 = 65%) and SAS (MD = - 4.30, 95%CI - 6.53-2.24, P < 0.0001, I2 = 0%) scores compared to the GFD group. CONCLUSION: LF-GFD therapy significantly enhances clinical symptoms and reduces anxiety and depression in individuals diagnosed with irritable bowel syndrome.

Medical Subject Headings (MeSH)
Irritable Bowel SyndromeHumansDiet, Gluten-FreeQuality of LifeAdultTreatment OutcomeDiet, Carbohydrate-RestrictedOligosaccharidesFODMAP Diet
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality78/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.50
Weight Score2.56
Normalized Score0.70
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