Efficacy of Low FODMAP Diet Intervention on Irritable Bowel Syndrome

Abstract

Background: Irritable Bowel Syndrome (IBS) occurs in 8-12% of the Bangladeshi population with a large impact on quality of life. Management, despite its prevalence, is still largely symptom-based with poor results. The Low FODMAP diet has been proven to be beneficial in Western populations, but implementation in Bangladesh is faced with particular cultural and food-related challenges. Methods & Materials: This prospective longitudinal study enrolled 100 adult patients meeting Rome IV criteria for IBS. Patients were instructed by a trained dietitian in a systematic manner regarding a culturally-adjusted Low FODMAP diet and followed up for 12 weeks. Outcome measures included improvement in symptoms, diet compliance, and change in quality of life determined by the Gastrointestinal Quality of Life Index (GIQLI) (1). Statistical analysis included chi-square tests, binary logistic regression, and Cox proportional hazards modeling. Results: 70% of participants reported symptom improvement after 12 weeks. Adherence to the diet was strongly associated with symptom improvement (χ² = 29.7, p<0.001) and was the optimal predictor of improvement (OR = 9.2, 95% CI: 3.41-24.81, p<0.001). IBS-D participants responded slightly better (OR = 2.40, 95% CI: 1.01-5.72, p=0.046). Severe symptoms decreased by 50%, and the proportion of participants with mild symptoms increased by 300%. GIQLI scores were greatly improved from 85±12 to 105±10 (p<0.001). Conclusion: Culturally-adapted Low FODMAP diet significantly improves symptoms and quality of life in Bangladeshi IBS patients, with diet adherence as the key predictor of success. Findings support incorporating Low FODMAP education into standard IBS care in Bangladesh.