Introduction To assess the clinical effectiveness of a Low FODMAP diet in clients referred with functional gut disorder.
Method Funding was sought to set up a Low FODMAP pilot clinic, 3.5 h per week for six months. A local protocol and care pathway was developed by the author. Potential clients were referred by the Consultant Gastroenterologist. An audit template developed and completed.
Results 19 Clients where recruited to the pilot phase. There was an overall 88% adherence to the three appointment care pathway. There was reduced use of antispasmodics, anti-diarrhoeals and laxatives from appointment one to appointment three. 56.3% of clients had the symptoms >10 years, with 100% having the symptoms more than 1 year. Thus it is very important to build a good rapport and relationship with the client from the start. The author does feel that the carepathway designed, of 3 appointments with 1 h long sessions, is essential in building this relationship. As IBS is known to be a relapsing condition it is important that all education is given accurately to prevent the client from re-entering the healthcare system at a later date. 64% of clients reported following the diet >75% of the time. 67% of clients reported having overall satisfactory relief of gut symptoms at appointment two, with 71% reporting overall satisfactory relief of gut symptoms at appointment three. The individual patient satisfaction questionnaire results at the 3rdappointment exhibited: 85% improved in bloating, 78% improved in abdominal/discomfort, 77% flatulence/wind improvement, 69% diarrhoea improvement, 46% improvement in constipation, 46% improvement in nausea and 62% improvement in energy. Only 13% of clients were re-referred back to the Consultant Gastroenterologist.
Conclusion Overall, 88% of clients completed the carepathway within the designated time. Only 13% were re-referred back to the Consultant Gastroenterologist for further investigation/treatment options. 71% of clients who completed the carepathway reported overall satisfactory relief of gut symptoms.
Disclosure of interest None Declared.
Staudacher HM, Whelan K, Irving PM, Lomer MCE. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with Irritable Bowel Syndrome. J Hum Nutr Diet 2011;24:487–495
Barrett JS, Gearry RB, Muir JG, Irving P, Rose R, Haines M, Shepherd SJ, Gibson PR. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther. 2010;31:874–882
Maxion-Bergemann, et al. Costs of irritable bowel syndrome in the UK aned US. Pharmacoeconomics 2006;24(1):21–37