Low-FODMAP vs regular rye bread in irritable bowel syndrome: Randomized SmartPill^® study

Area of Science:

• Gastroenterology
• Human Nutrition
• Microbiome Research

Background:

• Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder.
• Dietary modifications, such as low-FODMAP (fermentable oligo-, di-, mono-saccharides, and polyols) diets, are often used to manage IBS symptoms.
• Rye bread is a common staple food that can be high in FODMAPs.

Purpose of the Study:

• To compare the effects of regular versus low-FODMAP rye bread on IBS symptoms.
• To investigate gastrointestinal conditions, including colonic fermentation, intraluminal pressure, pH, and transit times, using SmartPill® technology.

Main Methods:

• A randomized, double-blind, controlled cross-over study involving female IBS patients (n=7).
• Patients consumed study breads (regular vs. low-FODMAP rye) during three consecutive meals in a single day.
• Intraluminal conditions were measured using the SmartPill® motility capsule.

Main Results:

• Hydrogen excretion, a marker of colonic fermentation, was significantly lower after consuming low-FODMAP rye bread compared to regular rye bread (P=0.028).
• No statistically significant differences were observed in overall gastrointestinal symptom scores, although flatulence was reduced with low-FODMAP bread (P=0.063).
• Intraluminal pressure correlated with symptom scores, but no significant differences in pH, pressure, or transit times were found between the two bread types.

Conclusions:

• Low-FODMAP rye bread effectively reduces colonic fermentation in IBS patients compared to regular rye bread.
• While low-FODMAP rye bread may offer some symptom relief, significant differences in overall intraluminal conditions and major symptom scores were not detected in this small study.