Ehealth: Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome

doi:10.3748/wjg.v20.i43.16215

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Nov 21, 2014; 20(43): 16215-16226
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16215

Table 1 Baseline characteristics of patients with irritable bowel syndrome

Characteristics	LFD, n = 42	LGG, n = 41	ND, n = 40	P = 0.23
Male/Female	8/34	14/27	11/29	0.30
Age (yr, range)	37 (18-71)	43 (20-74)	32 (18-73)	0.08
BMI (range)	23 (19-38)	22 (18-34)	23 (17-34)	0.50
Smoking				0.92
Current	5 (12)	6 (15)	6 (15)
Former	8 (19)	11 (27)	11 (27)
Never	24 (57)	22 (54)	22 (55)
Missing	5	2	1
Disease duration (yr, range)	2.6 (0.7-13)	1.8 (0.7-15)	2 (0.5-9)	0.20
Diagnosis subtypes				0.24
IBS-A, mixed	14 (33)	19 (46)	14 (35)
IBS-C, constipation	5 (12)	7 (17)	7 (17)
IBS-D, diarrhoeal	19 (45)	13 (32)	18 (35)
Unknown	4	2	1
Abdominal surgery	7 (17)	9 (22)	6 (15)	0.40
IBS related medication	16 (38)	15 (37)	18 (45)	0.40
IBS-SSS	327 ± 94	279 ± 84	319 ± 83	0.17
IBS-QOL	56 ± 21	64 ± 15	57 ± 22	0.24

Data are expressed as n (%), mean ± SD or median (range). FODMAP: Fermentable, oligosaccharides, disaccharides, monosaccharides and polyols; LFD: Low FODMAP diet; LGG: Lactobacillus rhamnosus GG; ND: Normal (Danish/Western) diet; IBS: Irritable bowel syndrome; SSS: Severity score system; IBS-QOL: IBS-quality of life; IBS-A: Alternation of constipation and diarrhoea; IBS-D: Irritable bowel syndrome-diarrhoea predominant; IBS-C: Irritable bowel syndrome-constipation predominant.

Table 2 Change of the irritable bowel syndrome-severity score system from baseline and after 6-wk

	IBS-D			IBS-A			IBS-C
	Baseline	6-wk	P value	Baseline	6-wk	P value	Baseline	6-wk	P value
LFD	320 ± 110	153 ± 136	< 0.01¹	359 ± 66	241 ± 111	0.01¹	289 ± 79	200 ± 62	0.14
LGG	297 ± 99	199 ± 102	0.01¹	251 ± 64	187 ± 122	0.04¹	321 ± 79	270 ± 145	0.74
ND	320 ± 89	257 ± 118	0.01¹	312 ± 99	322 ± 62	0.12	302 ± 70	277 ± 135	0.61

Change of the irritable bowel syndrome-severity score system from baseline and after 6-wk with low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (LFD) vs Lactobacillus rhamnosus GG (LGG) vs normal (Danish/Western) diet (ND) in different subtypes of IBS patients. Wilcoxon related samples: mean IBS-SSS ± SD. IBS: Irritable bowel syndrome; IBS-D: Diarrhoea predominant; IBS-C: Constipation predominant; IBS-A: Alternating of diarrhoea and constipation.

¹Significant result.

Table 3 Factors influencing positive changes in irritable bowel syndrome-severity score system at follow-up

Effect	Contrast	Diff SSS	Lower	Upper	P value
Age	Below 40 yr vs above	38.0246	-9.4334	85.4826	0.11
BMI	kg/m²	0.1812	-5.1063	5.4687	0.94
Gender	Females vs males	8.4693	-45.6473	62.5859	0.75
IBS subtype	IBS-A vs IBS-D	46.1096	0.6579	91.5613	0.04¹
IBS subtype	IBS-C vs IBS-D	50.3197	-7.1618	107.80	0.08
IBS medication	Yes vs no	-54.8795	-98.4657	-11.2933	0.01¹
Prior surgery	Yes vs no	-11.6029	-62.1065	38.9007	0.64
IBS-SSS	Per baseline SSS point	-0.4082	-0.6566	-0.1598	0.001¹
Smoking	Current vs never	66.0478	1.0815	131.01	0.04¹
Smoking	Former vs never	51.6542	3.8682	99.4401	0.03¹
IBS duration	Per year	4.7145	-3.0897	12.5188	0.23
Treatment group	LGG vs ND	-31.5190	-80.7763	17.7384	0.20
Treatment group	LFD vs ND	-75.3656	-126.81	-23.9216	0.004¹
Treatment group	LGG vs LFD	43.8466	-8.0787	95.7720	0.09

Irritable bowel syndrome-severity score system (IBS-SSS) outcome adjusted for baseline covariates: gender, age at diagnosis, smoking status, IBS subtype, surgery, medication, disease duration and body mas index (BMI). IBS duration, baseline IBS-SSS and treatment modality were used as regression variables ± 95%CI: Lower-upper). LFD: Low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet; LGG: Lactobacillus rhamnosus GG; ND: Normal (Danish/Western) diet; Diff SSS: IBS-SSS difference.

¹Significant result.

Table 4 Factors influencing positive changes in irritable bowel syndrome quality of life at follow-up

Effect	Contrast	Diff QOL	Lower	Upper	P value
Age	Below 40 yr vs above	-6.3823	-13.6223	0.8577	0.08
BMI	Per kg/m²	-0.2785	-1.1185	0.5615	0.51
Gender	Females vs males	2.2012	-6.3816	10.7840	0.61
IBS subtype	IBS-A vs IBS-D	-6.4508	-13.7027	0.8012	0.08
IBS subtype	IBS-C vs IBS-D	-4.3839	-13.5478	4.7800	0.34
IBS medication	Yes vs no	7.9708	1.0208	14.9209	0.02¹
Prior surgery	Yes vs no	6.1371	-1.9592	14.2335	0.13
IBS-QOL	Per baseline QOL point	-0.2972	-0.4739	-0.1205	0.001¹
Smoking	Current vs never	-6.2665	-16.7074	4.1743	0.23
Smoking	Former vs never	-6.9729	-14.6297	0.6839	0.07
Time from diagnosis	Per year	-0.1678	-1.4072	1.0716	0.78
Treatment group	LGG vs ND	7.2158	-0.5844	15.0160	0.06
Treatment group	LFD vs ND	3.7883	-4.4003	11.9769	0.36
Treatment group	LGG vs LFD	3.4275	-4.8844	11.7395	0.41

Irritable bowel syndrome quality of life (IBS-QOL) outcome adjusted for baseline covariates: gender, age, smoking status, IBS subtype, Prior abdominal surgery, IBS medication, IBS duration and body mass index (BMI). IBS duration, baseline IBS-QOL and treatment modality were used as regression variables ± 95%CI: Upper-lower). LFD: Low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet; LGG: Lactobacillus rhamnosus GG; ND: Normal (Danish/Western) diet; Diff QOL: IBS-QOL difference.

¹Significant result.

Citation: Pedersen N, Andersen NN, Végh Z, Jensen L, Ankersen DV, Felding M, Simonsen MH, Burisch J, Munkholm P. Ehealth: Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol 2014; 20(43): 16215-16226
URL: https://www.wjgnet.com/1007-9327/full/v20/i43/16215.htm
DOI: https://dx.doi.org/10.3748/wjg.v20.i43.16215