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Role of the DOMINO diet application for managing IBS in primary care and beyond
  1. Jan Tack1,2,
  2. Karen Van den Houte1,
  3. Florencia Carbone2
  1. 1Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Flanders, Belgium
  2. 2Department of Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
  1. Correspondence to Dr Jan Tack, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Flanders, Belgium; jan.tack{at}

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We thank Rej et al for their interest in our DOMINO trial paper.1 2 In their letter, they point out that while the DOMINO application yields a statistically significant gain in responder rate over traditional medical therapy with otilonium bromide, the numerical difference is limited, as it amounts to only 10% at weeks 4 and 8. We want to point out that these margins are in the order of magnitude of the gain in response rate over placebo in recent trials with novel drugs for the treatment of Irritable Bowel Syndrome (IBS) that have seen regulatory approval.3–6 In addition, the attractiveness of the dietary approach in our view is not predominantly determined by superior efficacy compared with medical therapy. As the patient, through the diet smartphone application, achieves …

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  • Contributors All authors, JT, KVH and FC, compiled the response to the letter by Rey, Sanders and Aziz. All authors, JT, KVH and FC, contributed to drafting and finalising the letter. JT submitted the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.