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, 2 (1), 15-20
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Low FODMAP Diet in Egyptian Patients With Crohn's Disease in Remission Phase With Functional Gastrointestinal Symptoms

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Low FODMAP Diet in Egyptian Patients With Crohn's Disease in Remission Phase With Functional Gastrointestinal Symptoms

Maha H Elhusseiny et al. JGH Open.

Abstract

Background and aim: Despite being in remission, functional gastrointestinal disease (FGID) in Crohn's disease (CD) patients can reduce their quality of life. The Egyptian daily diet contains a high amount of FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols). As the low FODMAP diet has been proven to be effective in irritable bowel syndrome worldwide, it was reasonable to take a step further and begin to study the effect of low FODMAP in Egyptian CD patients with FGID. The outcomes were assessed in terms of improvement in symptoms and hence the quality of life, and the factors that led to this improvement were also recorded.

Methods: In total, 100 CD patients with FGID in the remission stage who were already on a low-fiber diet (± lactose-free diet) were selected to follow the low FODMAP diet. A structured interview was performed after 3 months with a number of scored-scale questionnaires comparing symptoms before and after the diet and the impact on quality of life. Evaluation of the adherence, satisfaction, palatability, and affordability of the diet was performed. Different demographic data were also evaluated in correspondence with improvements in the quality of life.

Results: The mean score of FGID improvement was 38.45 ± 21.56%. The quality of life was significantly improved; 90% of female patients versus 49.4% males had a better quality of life. The households (not working) as well as those with morning jobs (6 hours) reported an increase in quality of life. Although the Egyptian low FODMAP diet was expensive (in terms of gluten-free wheat), 67% were adherent to it (18.16 ± 6.85).

Conclusion: As a first step in Egypt, the low FODMAP diet was effective in improving the quality of life of CD patients with FGID.

Keywords: Crohn's disease; FODMAP; diet; gastrointestinal symptoms.

Figures

Figure 1
Figure 1
Dot plot shows descriptive analysis of studied cases according to the percentage of improvement of the functional gastrointestinal disease symptoms. The minimum–maximum score (0.0–63.64) with mean value ± SD (38.45 ± 21.56). Postdiet score − Prediet score/ prediet score × 100.
Figure 2
Figure 2
Box and whisker diagram showing the distribution of the studied cases according to the percent total score of the SIBDQ (short inflammatory bowel disease questionnaire). The percent score was calculated: (average score − 1)/6 × 100. The results were statistically significant at P ≤ 0.05.
Figure 3
Figure 3
Correlation between adherence and quality of life after following the low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) diet for 3 months. Pearson coefficient was used to correlate between the both variables.r: Pearson coefficient *: Statistically significant at p ≤ 0.05

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