P0802 - Evaluating the Effects of Low FODMAP Diet and Normal Diet on Symptoms and Gut Function in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Vanessa Pamela Salolin-Vargas, MD¹, Mauricio Alejandro Saldana-Ruiz, MD², Huber Padilla-Zambrano, MD³, Mario Saul Lira-Castañeda, MS⁴, Maria Susana Ceriño-Peñaloza, MD², Yeison Cruz-Castillo, MD⁵, Martin Rodriguez-Alvarado, MS¹, Carlos Daniel Veloz-Ramirez, MS⁶, Muhammad Younas, ⁷, Wilfor Diaz Fernandez, MD⁸
1Gastroenterology Consultants, Mexico City, Distrito Federal, Mexico; 2Gastroenterology Consultants, Monterrey, Nuevo Leon, Mexico; 3Gastroenterology Consultants, Cartagena, Bolivar, Colombia; 4Gastroenterology Consultants, Durango, Durango, Mexico; 5Gastroenterology Consultants, Santo Domingo, Distrito Nacional, Dominican Republic; 6Gastroenterology Consultants, Ciudad Juarez, Chihuahua, Mexico; 7Gomal Medical College, Dera Ismail Khan, Dera Ismail Khan, North-West Frontier, Pakistan; 8Mayo Clinic, Boston, MA

Introduction: Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder marked by symptoms such as bloating, nausea, early satiety, and altered gut motility. This study presents an updated summary of observational and interventional studies assessing the impact of a low-FODMAP (fermentable oligo-, di-, and monosaccharides, and polyols) diet on gastrointestinal symptoms, quality of life, nutritional adequacy, and the gut microbiome in IBS patients. We aim to compare the impact of low-FODMAP (LFD) to normal diet in patients with IBS.

Methods: A comprehensive search was performed on PubMed, Embase, and Cochrane Library for studies comparing the effects of LFD and regular diet in patients with IBS. The main outcomes were Irritable Bowel Syndrome – Symptom Severity Score (IBS-SSS), and IBS-related quality of life (IBS-QoL). Statistical analyses were performed using Review Manager 5.4.1(Cochrane Collaboration). The I2 test was employed for heterogeneity assessment, while the risk of bias was evaluated utilizing ROBINS-I.

Results: A total of nine studies were included in the meta-analysis. When focusing exclusively on those utilizing the validated IBS-SSS questionnaire, a small-to-moderate standardized mean difference in symptom reduction was observed (SMD = -0.43; 95% CI: -0.60 to -0.26; I² = 78%) favoring LFD. The LFD diet also led to an improvement in IBS-QoL scores compared to a control diet, with a relative risk (RR) of 1.00 (95% CI: 0.86 to 1.17; p = 0.005). Subgroup analyses based on factors such as adherence, age, duration of intervention, abdominal pain, IBS subtype, and outcome measures showed no statistically significant differences.

Discussion: The LFD diet appears to be effective in reducing gastrointestinal symptoms and improving the quality of life in individuals with IBS compared to control diets. While the current evidence supports its short-term benefits, further research is needed to determine the long-term effects of the diet on nutritional adequacy and the gut microbiome. Future studies should also investigate the impact of the diet on specific IBS subtypes and other potential influencing factors to optimize its clinical application.


Figure: IBS-SSS questionnaire.


Figure: Effect of LFD on QoL in IBS patients.

Disclosures:
Vanessa Pamela Salolin-Vargas indicated no relevant financial relationships.
Mauricio Alejandro Saldana-Ruiz indicated no relevant financial relationships.
Huber Padilla-Zambrano indicated no relevant financial relationships.
Mario Saul Lira-Castañeda indicated no relevant financial relationships.
Maria Susana Ceriño-Peñaloza indicated no relevant financial relationships.
Yeison Cruz-Castillo indicated no relevant financial relationships.
Martin Rodriguez-Alvarado indicated no relevant financial relationships.
Carlos Daniel Veloz-Ramirez indicated no relevant financial relationships.
Muhammad Younas indicated no relevant financial relationships.
Wilfor Diaz Fernandez indicated no relevant financial relationships.

Vanessa Pamela Salolin-Vargas, MD¹, Mauricio Alejandro Saldana-Ruiz, MD², Huber Padilla-Zambrano, MD³, Mario Saul Lira-Castañeda, MS⁴, Maria Susana Ceriño-Peñaloza, MD², Yeison Cruz-Castillo, MD⁵, Martin Rodriguez-Alvarado, MS¹, Carlos Daniel Veloz-Ramirez, MS⁶, Muhammad Younas, ⁷, Wilfor Diaz Fernandez, MD⁸. P0802 - Evaluating the Effects of Low FODMAP Diet and Normal Diet on Symptoms and Gut Function in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.