The effectiveness of an internet-based low FODMAP diet education program to improve symptoms of patients with IBS
Adams, Rachel Loran
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Irritable Bowel Syndrome (IBS) is the most commonly diagnosed gastrointestinal disorder in the United States. The Low FODMAP Diet (LFD) is an effective treatment for IBS symptoms in 50-80% of people. The purpose of this multi-phase study was to determine if an internet-, module-based program (“The FODMAP Fix”) of the elimination phase of the Low FODMAP Diet (LFD) would improve symptoms and quality of life in patients with IBS. Phase 1 included a formal survey as part of the needs assessment to inform the development of the program. Phase 2 was designed as a four-week, randomized, controlled trial to test the effectiveness of the program. After failed recruitment and a high rate of attrition, the trial was modified and Phase 3 was launched. Phase 3 is a non-randomized, trial with pre- and post-intervention assessments including adults 18 to 65 years of age who identify as having IBS. One hundred thirty-five participants were screened, and 52 (39%) were invited to participate in the program. Fifteen participants completed baseline and final assessments. IBS Symptom Severity Scale (IBS-SSS), Quality of Life (IBS-QOL) indices, and a self-efficacy (SE) survey were used to assess outcomes. Due to the high dropout rate, the study was underpowered to detect changes in the IBS-SSS, IBS-QOL, and SE assessments. While the trial was underpowered to detect differences in the pre- and post-assessments, most participants did experience improvement in symptom severity and reported this internet-based intervention was an effective method to educate on the LFD. When asked if they felt this approach would be at least as effective as a one-on-one visit, 73% responded affirmatively. This same percentage stated they would recommend the program to others suffering from IBS. Future trials are needed to assess the effect of internet-based LFD interventions on IBS symptom management and how to achieve better engagement and completion rates of internet-based, diet interventions.