Low FODMAPs Diet Intervention In Patients With Irritable Bowel Syndrome

Objective:To investigate the effects of low FODMAPs diet on symptoms,quality of life,intestinal flora and short chain fatty acid concentrations in patients with irritable bowel syndrome,at the same time,the development of low FODMAPs recipes based on food exchange method.Methods:105 outpatients with IBS were selected from Yangzhou city in Jiangsu Province,two hospitals as the research object,randomly divided into two groups,the intervention group(lowFODMAPs diet)55 cases,the control group(routine diet)in 50 cases,the general situation questionnaire,quality of life scale(IBS-SSS scale,IBS-QOL scale,SF-36 scale)and satisfaction questionnaire were used to investigate the symptoms,quality of life and satisfaction of the two groups before and after the intervention;Randomly selected 15 cases of intervention group and 10 cases of control group before and after the intervention of fecal specimens,16SrDNA high throughput sequencing and GC-MS detection to analyze the relative abundance,diversity and short chain fatty acid concentration changes before and after the intervention;Combined with food exchange list and Monash University Low FODMAPs Diet App,to develop scientific and reasonable diet for patients with IBS.Results:1 The effect of low FODMAPs diet on symptoms and quality of life in patients with IBS(1)IBS-SSS scale:there were no statistically significant differences between the two groups of patients with baseline symptom score(P>0.05),1 months,3 months after the group comparison,results showed that the symptoms of abdominal pain,the frequency of abdominal pain,defecation satisfaction and the influence on life were improved in the intervention group(P<0.05),while the control group symptoms the improvement were not statistically significant(P>0.05).After intervention,the total score of the intervention group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).(2)IBS-QOL,SF-36 scale:there were no significant difference in baseline quality of life between the two groups(P>0.05);1 months,3 months after the group comparison,The DY(Dysphoria),IN(Interference with activity),HW(Health worry),FA(Food avoidance),SR(Social reaction),SX(Sexual),and the total score of the IBS-QOL scale in the intervention group were all improved(P<0.05),SF-36 scale,PF(Physical Function),RP(Role-Physical),GH(General Health),VT(Vitality),RE(Role-Emotional),MH(Mental Health)and other dimensions and the total score were improved(P<0.05);In the control group,the DY(Dysphoria),HW(Health worry),RL(Relationship),total score of the IBS-QOL scale and RP(Role-Physical),GH(General Health),VT(Vitality)and total score of the SF-36 scale were improved(P<0.05).After intervention,the scores of IBS-QOL and SF-36 in the intervention group were better than those in the control group,in the IBS-QOL scale DY(Dysphoria)dimension,the improvement of PF(Physical Function)scale and GH(General Health)dimension of the SF-36 scale were higher than that of the control group(P<0.05).(3)Satisfaction questionnaire:the satisfaction scores of the intervention group at 1 and 3 months were higher than those in the control group,the difference were statistically significant(P<0.01).2 Different effects of low FODMAPs diet on intestinal flora in patients with IBSThere were no significant difference in the concentration of short chain fatty acids(SCFA)between the two groups before and after intervention(P>0.05).Before and after the intervention,the 9 phylum with relatively high abundance were identified,Among them,the highest abundance of the 4 phylum were Firmicutes,Bacteroidetes,Proteobacteria,and Actinobacteria,there were no significant difference between the two groups before and after intervention(P>0.05).In group comparison,the intervention group of Firmicutes content was increased,and control group of Proteobacteria was decreased,the differences were statistically significant(P<0.05);In the genus level,the content of bifidobacteria were not statistically significant in the two groups of patients before and after intervention(P>0.05).Two Most of the patients in NMDS samples are uniformly distributed in the PCoA,the first and the second principal component contribution rate were 55.08%and 20.90%,before and after the intervention sample no scattered and isolated phenomenon was obvious.3 The food exchange method was used to make a quantitative comparison of low FODMAPs recipes.Conclusion:(1)Low FODMAPs diet intervention could improve the degree of abdominal pain,the frequency of abdominal pain,defecation satisfaction and the impact on life,and the overall improvement of symptoms were better than that of the control group.(2)Low FODMAPs diet intervention could improve the quality of life scores,especially dysphoria,physical function and general health.(3)Low FODMAPs diet intervention had higher patient satisfaction.(4)The low FODMAPs diet did not alter the SCFA concentration in the stool of patients,but could enhance the abundance of intestinal microflora,which was beneficial to the intestinal microecology.