Article Text
Abstract
Introduction A low FODMAPs diet has been showed to be an effective dietary intervention for the management of irritable bowel syndrome (IBS). Traditionally the complex low FODMAP diet is thought to require patient education by a dietitian, a labour intensive process on a one-on-one basis. We hypothesised that group education might offer a cost effective alternative.
Methods 167 patients with a Rome III IBS diagnosis who completed low FODMAP dietary education therapy were analysed according to whether they underwent individual (n = 68, 54 f, mean age 39) or group (n = 99, 77 f, mean age 43) sessions. Symptoms were assessed at baseline and follow up (median duration 63 days after treatment ended) via self-administered questionnaire. The primary endpoint was a composite symptom severity score (scale of 0–5), based on pain, bloating, constipation and diarrhoea. A reduction of ≥1 pt in score was used for responder analysis.
Results Across all patients, at the end of low FODMAP diet there was an improvement in symptom severity (from 2.4 to 1.6, p < 0.001). A greater improvement was seen in those receiving individual education compared to those with group (2.7 to 1.6 vs 2.4 to 1.6 respectively, p < 0.01). There were 63 responders, 34/68 individual vs. 29/99 group (chi-sq p = 0.007). The cost per patient for initial appointment and follow up is £30.54 for group and £73.68 for individual education.
Conclusion This study suggests that the complexity of a low FODMAP diet requires delivery on an individual rather than group basis, albeit being more expensive.
Disclosure of Interest None Declared