Role of low FODMAP diet in patients with Irritable bowel syndrome (IBS) : a randomized trial

Irritable bowel syndrome (IBS) is a functional bowel disorder with a global prevalence of 11% and contributes up to 60% of gastroenterology outpatient appointments. It profoundly affects health-related quality of life likely due to its chronic nature and the co-existence of gastrointestinal (GI) and extra-intestinal symptoms. An incomplete understanding of the pathophysiology of IBS and its phenotypic heterogeneity has led to symptom-directed treatment approaches including antispasmodics and anti-diarrheals. However, less than 40% of patients are satisfied with their current treatments.  Dietary restriction of fermentable carbohydrates (fermentable oligosaccharides, monosaccharides, disaccharides and polyols- FODMAP) is now widely used in the management of IBSD. These carbohydrates increase small intestinal water and colonic gas. Their dietary restriction has been investigated in few trials with up to 70% of patients reporting symptomatic benefit.  However there is not even a single randomized study on Indian population evaluating effect of low FODMAP diet in IBSD patients, which motivated us to conduct this study.