Low-FODMAP Diet May Ease Symptoms of Postprandial Dyspepsia

TOPLINE Adults with postprandial distress syndrome (PDS) who followed a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) experienced greater symptom relief and improved quality of life over 6 weeks than those who followed traditional dietary advice. METHODOLOGY - Prior evidence offers limited guidance on the dietary management of PDS. Researchers conducted a randomized trial at a UK hospital to compare a low-FODMAP diet with traditional dietary advice in adults who met Rome IV criteria for PDS and had normal findings on upper gastrointestinal endoscopy. - After a 30-45-minute dietetic consultation, participants were randomly assigned to follow the low-FODMAP diet or traditional dietary advice for 6 weeks. - The low-FODMAP diet involved restricting fermentable carbohydrates, whereas traditional dietary advice involved eating small, frequent meals and eliminating caffeine, alcohol, carbonated beverages, and high-fat or spicy foods. - The primary endpoint was a clinically meaningful reduction in the PDS subscale score on the Leuven Postprandial Distress Scale, reported by the participants at 6 weeks. Response was assessed using two thresholds: ≥ 0.5 points (indicating a minimally important clinical difference) and ≥ 0.7 points (indicating a more stringent response). - Secondary endpoints included self-reported changes in quality of life and gastrointestinal and nongastrointestinal somatic symptoms as well as achievement of adequate relief from dyspeptic symptoms. TAKEAWAY - The final sample included 60 participants (mean age, 39.6 years; 78% women); 31 followed the low-FODMAP diet and 29 followed traditional dietary advice. - A greater percentage of participants in the low-FODMAP diet group than in the traditional dietary advice group achieved a ≥ 0.5-point reduction (61.3% vs 38.0%) and a ≥ 0.7-point reduction (61.3% vs 20.6%) in the PDS subscale, with absolute differences of 22.5 and 36.4 percentage points, respectively (P < .05 for both). - Overall, 63% of participants also had irritable bowel syndrome. The reduction in the PDS subscale score with low-FODMAP diet remained consistent regardless of the presence or absence of irritable bowel syndrome. - Participants following a low-FODMAP diet reported greater reductions in postprandial distress scores; greater relief from early satiety, fullness, pain, and belching; higher rates of adequate relief; and greater improvements in quality of life and reductions in overall gastrointestinal symptoms than those following traditional dietary advice (P < .05 for all). IN PRACTICE "Based on the convergent evidence from our study and recent publications, we recommend that a low FODMAP diet be considered as a second-line dietary approach in PDS, particularly for patients who have not responded to traditional dietary modifications," the authors wrote. SOURCE The study was led by Mohamed G. Shiha, University of Sheffield, Sheffield, England. It was published online in Clinical Gastroenterology and Hepatology. LIMITATIONS Researchers could not blind the participants to their assigned diet. They did not use a validated tool to objectively measure dietary adherence or actual FODMAP intake. A placebo group was missing. DISCLOSURES The study received funding from the American College of Gastroenterology and the Rome Foundation. The authors reported having no relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.