Introduction Avoidance of fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) is an effective treatment for irritable bowel syndrome (IBS) and is widely used in Australasia. The complexity of this strategy requires that dietitians undergo specialist training prior to successful implementation of the diet. Differences between Australian and UK food availability, composition and intake are such that it is not clear whether this dietary approach is effective outside Australasia. We aimed to develop and implement the low FODMAP diet in the UK and evaluate its efficacy in the management of IBS.

Methods An Australian dietitian with 3 years' experience in the low FODMAP diet joined a UK Consultant Gastroenterologist, also experienced in the diet, and a UK Consultant Dietitian with a special interest in IBS. Resources were developed and tailored to the UK context. Extensive review of food availability and FODMAP composition of processed foods was undertaken via supermarket research. Dietary intake and food choice was examined by patient consultation. Input from experienced UK dietitians ensured appropriate dietary language was used in the resources. Subsequently, the diet was implemented and service evaluation on 8-week symptom response was conducted. The evaluation consisted of Likert scale questions assessing change in severity of individual and global symptoms. This was compared with data collected from patients receiving standard dietary advice.

Results Marked differences in the UK and Australian diets were noted, including greater availability of pre-prepared foods, frequent addition of high FODMAP ingredients (eg, oligofructose) to packaged foods and differences in the availability and consumption of fruit and vegetables. Accordingly, implementation of the diet in the UK required marked adaptation in its application and supporting materials. Early evaluation data indicate that although standard advice is effective, a low FODMAP approach offers additional benefit for bloating and flatulence (Abstract 064).

Conclusion The low FODMAP diet appears to be a promising strategy for managing IBS in the UK. The success of this complex diet requires delivery by an experienced dietitian and the use of comprehensive and relevant education material.