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Low FODMAP diet in children and adolescents with functional bowel disorder: A clinical case note review
Stephanie C Brown1, Kevin Whelan2, Richard B Gearry3,4
1Department of Paediatrics University of Otago Christchurch Christchurch New Zealand.
Insights
The low FODMAP diet (LFD) effectively reduced symptoms in most children with functional bowel disorders (FBD), including irritable bowel syndrome (IBS). This dietary approach offers a promising treatment strategy for pediatric FBD management.
Area of Science:
- Pediatric Gastroenterology
- Dietary Interventions
- Functional Bowel Disorders
Background:
- Functional bowel disorders (FBD), including irritable bowel syndrome (IBS), affect up to 20% of children, causing significant quality of life issues.
- The multifactorial etiology of FBD lacks clear organic causes, necessitating diverse treatment approaches.
- Fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) are poorly absorbed carbohydrates implicated in gastrointestinal distress.
Purpose of the Study:
- To investigate the efficacy of the low FODMAP diet (LFD) as a dietary intervention for children diagnosed with FBD.
- To evaluate symptom resolution and overall improvement in pediatric patients with FBD managed with an LFD.
Main Methods:
- A retrospective review of clinical case notes for children with FBD managed on an LFD.
- Collection of anthropometric and clinical data by a pediatric gastroenterology dietitian.
- Assessment of diet outcomes using an IBS satisfaction survey and statistical analysis.
Main Results:
- Complete symptom resolution was observed in 92% with bloating, 87% with diarrhea, and 77% with abdominal pain.
- Overall, 79% of participants reported an improvement in their gastrointestinal symptoms.
- Fructans were identified as the most frequent carbohydrate trigger for symptoms.
Conclusions:
- The low FODMAP diet (LFD) demonstrates utility as a dietary treatment for pediatric FBD.
- This study contributes to the limited evidence base supporting FODMAP-based dietary interventions in children.
- Further prospective research is recommended to validate these findings.
Background And Aims:
Functional bowel disorders (FBD), such as irritable bowel syndrome (IBS), are increasingly more common in children and affect up to 20% of children. The etiology is multifactorial with no clear organic cause. Symptoms are recurrent and are associated with a reduced quality of life, school absences, and psychological challenges. Treatment options are variable. FODMAPs are short-chained carbohydrates, poorly absorbed by the gastrointestinal tract due to their increased osmotic activity and excess gas production from the bacterial fermentation process. There is a paucity of data examining dietary interventions that restrict carbohydrates in children with IBS. The aim of this study was to examine the use of the low FODMAP diet (LFD) in children with an FBD.
Methods:
A retrospective clinical case note review of children with an FBD managed with an LFD was undertaken. Anthropometry and clinical data were collected by a pediatric gastroenterology dietitian. An IBS satisfaction survey was used to assess diet outcomes. Statistical analyses were completed using Excel.
Results:
Of the 29 children included in this study, complete resolution of gastrointestinal symptoms was observed for 11 of 12 (92%) of those with bloating, 13 of 15 (87%) of those with diarrhea, and 17 of 22 (77%) of those with abdominal pain. Twenty-three (79%) participants reported an improvement of symptoms. Fructans were the most common symptom-causing carbohydrate.
Conclusion:
The LFD is a useful dietary treatment strategy for children with FBD. This study adds to the small body of evidence supporting FODMAP dietary interventions in children with FBD. Further prospective studies are required.
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