An evaluation of Dietetic Service in Functional dyspepsia: comparison of Low FODMAP diet with standard dietetic advice.

Christopher Duff, Dr Bradley Kendall, Prof Gerald Holtmann, Amy Nevin, Dr Heidi Staudacher
Bond University, Princess Alexandra Hospital, University of Queensland, Gippsland Southern Health Service

ABSTRACT

Background or Problem/ Issue:

Functional dyspepsia (FD) is a gastrointestinal disorder characterised by symptoms including postprandial pain and early satiety. Observational data suggests certain foods and/or dietary constituents may provoke symptoms. Data for effective dietary approaches for FD is lacking, although a diet low in fermentable carbohydrates (low FODMAP diet) is often recommended in clinical practice.

Method or What you did?

We performed an observational study to compare the effectiveness of low FODMAP dietary advice (LFD) with standard dietary advice (STD; e.g. healthy eating, reduce intake of caffeine/alcohol) in patients referred with FD. At interim analysis, complete symptom data from 35 patients with FD attending an initial and review dietetic gastroenterology outpatient appointments at Princess Alexandra Hospital were available. Of these, 25 patients received LFD advice and 10 received STD advice. The 22-item Structured Assessment of Gastrointestinal Symptoms (SAGIS) questionnaire (1) was completed at each visit and epigastric score (max 28 points) and total SAGIS score (max 88 points) calculated. Adherence to dietary advice was recorded.

Results or Outcomes:

Patients receiving LFD advice demonstrated a greater reduction in epigastric domain score (-4.1 vs + 0.7, p =0.015) and total SAGIS score (-10.4 vs – 1.55, p =0.031) compared with STD. A greater proportion of patients receiving LFD advice achieved a 30% reduction in epigastric score compared with STD (52% vs 10%, p=0.024). Adherence to advice did not differ between LFD and STD (76% vs 60%, p=0.292).

Conclusions or Practice Implications:

These findings suggest LFD may be beneficial for improving upper gastrointestinal symptoms in FD. A randomised controlled trial is required to substantiate these findings.


BIOGRAPHY

Chris conducted a part of this study as a component of his Masters program in his final year. The study has since continued and he is still heavily involved. He has a keen interest in the dietary management of gastrointestinal symptoms. Chris is now working in regional Victoria, across several areas of dietetics.

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