Randomised clinical trial : low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome

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Laatikainen , R , Koskenpato , J , Hongisto , S -M , Loponen , J , Poussa , T , Hillilä , M & Korpela , R 2016 , ' Randomised clinical trial : low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome ' , Alimentary Pharmacology & Therapeutics , vol. 44 , no. 5 , pp. 460-470 . https://doi.org/10.1111/apt.13726

Title: Randomised clinical trial : low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome
Author: Laatikainen, R.; Koskenpato, J.; Hongisto, S. -M.; Loponen, J.; Poussa, T.; Hillilä, Markku; Korpela, R.
Contributor: University of Helsinki, Department of Medicine
University of Helsinki, Department of Food and Nutrition
University of Helsinki, Department of Medicine
University of Helsinki, Medicum
Date: 2016-09
Language: eng
Number of pages: 11
Belongs to series: Alimentary Pharmacology & Therapeutics
ISSN: 0269-2813
URI: http://hdl.handle.net/10138/166643
Abstract: BackgroundGrains are high in FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms. AimTo evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS. MethodsThe study was conducted as a randomised double blind controlled cross-over study (n=87). Participants were supplied with both regular rye bread and low-FODMAP rye bread for 4weeks. Symptoms were measured with a symptom severity scoring system (IBS-SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries. ResultsDietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low-FODMAP rye bread (P-values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [-3 (95% CI): -6 to -1, P=0.02] but no differences were detected in IBS-SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low-FODMAP bread period (median 52.9 vs. 72.6; P=0.01). ConclusionsLow-FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low-FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS-SSS. Nonetheless, inclusion of low-FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.
Subject: QUALITY-OF-LIFE
GASTROINTESTINAL SYMPTOMS
DIETARY-MANAGEMENT
WHEAT BREAD
FIBER
CONSTIPATION
IBS
METAANALYSIS
RESTRICTION
GRAINS
3121 General medicine, internal medicine and other clinical medicine
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