The effectiveness of an internet-based low FODMAP diet education program to improve symptoms of patients with IBS
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.