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P646 Low FODMAPs diet as a magic bullet in reducing symptoms in different gastrointestinal diseases

Testa A., Imperatore N., Rispo A., Capone P., Rea M., Nardone O.M., Opramolla A., Tortora R., Caporaso N., Castiglione F.

University “Federico II” of Naples, Department of Clinical Medicine and Surgery, Naples, Italy

Background

Several recent studies have shown FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) free diet is efficient in subjects with Irritable Bowel Syndrome (IBS). Patients with Inflammatory Bowel Diseases (IBD) and celiac disease (CD) can experience functional gastrointestinal symptoms not related to inflammation, but data about the use of low FODMAPs diet in these settings are still scarce.

Aim: To evaluate the usefulness of a low FODMAPs diet in patients with IBS, IBD and CD on gluten-free diet (GFD).

Methods

We performed a dietetic interventional prospective study evaluating the effect of a low FODMAPs diet in patients with IBS, CD following at least a 1-year-GFD and IBD without signs of active inflammation, who experienced functional symptoms. Each subject was submitted to a low FODMAPs diet, after filling out questionnaires on quality of life and symptoms (IBS-SSS and SF-36), and was re-evaluated after 1 and 3 months.

Results

127 subjects were enrolled: 56 with IBS, 30 with IBD and 41 with CD. The analysis of the IBS-SSS explained if the symptomatology reported by the patient was mild (score <175), moderate (score 175–300) or severe (score 300–500) before starting the diet (T0) and one month (T1) and three months (T3) after prescription of a low FODMAPs diet. The overall average score of the study population was 250±113 SD at T0, 146±68 SD at T1 and 81±50 SD at T3 (p<0.001).

Furthermore, by analysing the SF-36 questionnaire, we did not observe any significant difference between the groups in terms of response to diet (p=NS), even if we observed a clinical improvement from T0 to T3 after the start of the diet for the most of the questionnaire's domains.

Conclusion

A low FODMAPs diet could be a valid tool to contrast functional disorders in patients with IBS, non-active IBD and CD on GFD, thus improving the quality of life and the social relations.