Low fermentable oligo-, di-, monosaccharides and polyols (FODMAP) in addition to a strict gluten-free diet, diet beneficial for GI symptoms in patients with celiac disease, according to a recent study published in the Clinical Gastroenterology and Hepatology.
A gluten-free diet usually leads to mucosal remission in celiac disease, but persistent symptoms are common. A Low FODMAP diet is an established treatment for irritable bowel syndrome (IBS).
A group of researchers have assessed the efficacy of a moderately low FODMAP diet on persistent symptoms in treated celiac patients.
A randomized controlled trial was performed 2018-2019 in 70 adults with biopsy-proven celiac disease. Inclusion criteria: persistent gastrointestinal symptoms defined by Gastrointestinal Symptom Rating Scale-IBS version (GSRS-IBS) score≥ 30, gluten-free diet adherence≥ 12 months, serological and mucosal remission.
Participants were randomized to a low FODMAP-gluten-free diet (intervention) or the usual 58 gluten-free diets (control). GSRS-IBS was recorded at baseline and weeks 1-4, and 59 Celiac Symptom Index (CSI) at baseline and week 4. Statistics: marginal models for repeated data and analyzes of covariance.
The Results of the study are:
The researchers included 34 participants in the intervention and 36 in the control group. Time development of GSRS-IBS total scores differed significantly between the groups, evident after one week (mean difference (95% CI) intervention versus control (-8.2 (-11.5,-5.0)) and persisting through week 4 (-10.8 (-14.8,-6.8)). Moreover, significantly lower scores were found for the dimensions pain, bloating, diarrhoea and satiety (Pinteraction≤ 0.04), but not constipation (Pinteraction=0.43). FODMAP intake during the intervention was moderately low (mean 8.1 g/day (95% CI 6.7, 9.3)). CSI was significantly lower in the intervention group at week 4 (mean differences (95% CIs): -5.8 (-9.6,-2.0).
Thus, the researchers concluded that a short-term moderately low FODMAP diet significantly reduced 71 gastrointestinal symptoms and increased celiac disease-specific health, and should be considered for the management of persistent symptoms in celiac disease.
Reference:
A low FODMAP diet reduces symptoms in treated celiac patients 2 with ongoing symptoms – a randomized controlled trial by Frida van Megen et al. published in the Clinical Gastroenterology and Hepatology.
https://www.cghjournal.org/article/S1542-3565%2822%2900034-9/pdf