"Efficacy of the Low-Fodmap Diet in Managing Irritable Bowel Syndrome Symptoms: A Prospective Observational Study at Baghdad Teaching Hospital"

Abstract

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder affecting 5-10% of individuals globally, characterized by abdominal pain, bloating, and altered bowel movements without identifiable structural abnormalities. The prevalence of IBS varies regionally, with Iraq reporting a rate of 7.9%, notably higher among women. Treatment strategies often focus on symptom management, and the low-FODMAP diet has emerged as a promising dietary intervention. This study aimed to evaluate the efficacy of the low-FODMAP diet in reducing IBS symptoms and assessing overall symptom improvement. Conducted at Baghdad Teaching Hospital’s specialized clinics from March 1 to August 31, 2023, this prospective observational study included IBS patients under 45 years old, diagnosed by Rome IV criteria, and with normal CBC, TSH, and antitissue transglutaminase antibody tests. Patients with IBS-alarm symptoms, those aged 45 or older, or with co-existing conditions were excluded. Data were collected through interviews and symptom assessments rated on a four-point scale. The Wilcoxon signed-rank test analyzed changes in symptom severity. Ethical approval and informed consent were obtained. The study’s demographic profile revealed that 50% of participants were aged 30-39, 62% were female, and 86% were urban residents. Educational levels varied, with 34% having attended college. Employment status showed that 60% were employed and 64% were married. Smoking was reported by 20%, and alcohol use was minimal at 2%. Monthly income was almost evenly split between sufficient (52%) and insufficient (48%). BMI distribution indicated 46% were overweight and 38% were obese. IBS subtypes included constipation-predominant (46%), mixed (28%), unclassified (18%), and diarrhea-predominant (8%). Significant improvements were observed in abdominal pain, bloating, and other symptoms post-diet (p < 0.001), with 74% of participants reporting general improvement. No significant correlation was found between demographic factors and symptom relief (p-values > 0.05), highlighting the broad effectiveness of the low-FODMAP diet in alleviating IBS symptoms. The results emphasize the diet's potential in managing IBS, though individual adherence and dietary implementation quality may affect outcomes.