Full Article
Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn people with irritable bowel syndrome, low FODMAP diets improve symptoms compared with other dietary guidance
Black CJ, Staudacher HM, Ford AC Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2022;71:1117-26.
Review question
In people with irritable bowel syndrome (IBS), what is the effect of a diet low on fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) on IBS symptoms compared with other dietary advice, sham, or habitual or usual diet?
Background
IBS is a common condition that affects the large intestine but doesn’t cause any damage to it. There is no test to diagnose IBS, and its cause is unknown. People with IBS often experience symptoms like constipation, diarrhea, stomach pain or cramps, bloating, and gas. These symptoms may be managed with medications, probiotics, stress management techniques, or diet changes.
Low FODMAP diets omit foods that are poorly absorbed in the bowel. Some of these foods include garlic, onions, and many types of beans (a full list is easily found on the Internet). Other dietary advice from the British Dietetic Association (BDA) and the UK National Institute for Health and Care Excellence (NICE) suggests eating small, regular meals; staying hydrated; drinking less tea, coffee, alcohol, and carbonated drinks; and limiting the amount of fruit eaten. This review looks at how well a low FODMAP improves IBS symptoms.
How the review was done
The researchers did a systematic review of studies available up to April 2021. They found 13 randomized controlled trials that included 944 people.
The key features of the studies were:
- people were at least 18 years of age and were diagnosed with IBS;
- studies compared low FODMAP diets with BDA/NICE dietary advice, sham dietary advice, habitual diet, alternative dietary advice, or a high FODMAP diet; and
- people followed the diet for 3 weeks to 3 months.
What the researchers found
- Low FODMAP diets improved IBS symptoms in more people compared with all other diets.
The quality of the evidence was low, which means that new studies might show different results.
Conclusion
In people with IBS, there is low-quality evidence that low FODMAP diets improve symptoms more than other dietary advice.
Low FODMAP diet vs. other diets for irritable bowel syndrome (IBS)
| Comparison diet | Number of trials (number of people) | Effect of low FODMAP diet on IBS symptoms |
| BDA/NICE dietary advice* | 5 (486) | Symptoms improved for more people eating a low FODMAP diet |
| Sham dietary advice | 2 (149) | Symptoms improved for more people eating a low FODMAP diet |
| Habitual diet | 4 (203) | Symptoms improved for more people eating a low FODMAP diet |
| Alternative dietary advice | 1 (66) | Symptoms improved for more people eating a low FODMAP diet |
| High FODMAP diet | 1 (40) | Symptoms improved for more people eating a low FODMAP diet |
Related Topics
Glossary
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
Related Evidence Summaries
-
Nutritional strategies can improve body composition in underweight and overweight older adults
JBI Database of Systematic Reviews and Implementation Reports (2016)
-
Interpretive labelling on restaurant menus decreases calories ordered and consumed
Journal of the Academy of Nutrition & Dietetics (2014)
-
Financial incentives can help motivate people to make lifestyle changes
Preventive Medicine (2015)
