Study Shows Low FODMAP Diet Reduces IBD Symptoms But Not Gut Inflammation

Medically reviewed by Onikepe Adegbola, MD, PhD

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (Low FODMAP Diet) can relieve symptoms of inflammatory bowel disease (IBD), but it is not enough to reduce gut inflammation, concludes a recent meta-analysis done by Chinese researchers. The researchers also found that patients receiving a low FODMAP diet did not report a positive change in stool consistency either.

This 2022 study was titled “A Low-FODMAP Diet Provides Benefits for Functional Gastrointestinal Symptoms but Not for Improving Stool Consistency and Mucosal Inflammation in IBD: A Systematic Review and Meta-Analysis,” and was published in Nutrients. The meta-analysis summed up data from 9 different studies, including 446 participants.

What Can You Expect From A Low FODMAP Diet In IBD?

Indeed, this study concluded that patients with IBD can derive some benefits from a low FODMAP diet, including a significant improvement in overall IBD symptoms. Moreover, this study showed that a significant overall symptomatic improvement could be expected in Crohn’s disease as well as ulcerative colitis.

Regarding individual symptoms, IBD patients using a low FODMAP diet to manage IBD can expect significant improvements in bloating, flatulence, pain, fatigue, and loud bowel sounds. This may also lead to a perception of improved quality of life by IBD patients.

What Can’t A Low FODMAP Diet Achieve In IBD?

This study showed that a low FODMAP diet in IBD might not improve stool consistency, disease activity, and fecal calprotectin, a marker of gut inflammation. So, IBD patients should not expect that a low FODMAP diet alone could induce remission of their IBD.

Also, IBD patients experiencing symptoms of diarrhea may not obtain relief from those symptoms. The authors pointed out that diarrhea and disease activity go hand in hand in most IBD patients, as active disease-induced damage to gut mucosa is the cause of diarrhea.

What Is The Message Here For IBD Patients?

A Low FODMAP diet remains an important strategy to manage the symptoms of IBD. Yet, its role remains limited to improvements in symptoms and quality of life. Yet, the symptoms of diarrhea may remain unaddressed even after using a low-FODMAP diet.

However, disease-modifying treatment strategies would still be needed in IBD patients to induce or maintain remission and lower fecal calprotectin levels since a low-FODMAP diet alone may fail to achieve these endpoints.

The authors also cautioned that IBD patients adhering to a low FODMAP diet could develop certain nutritional deficiencies, especially over the long term. Supplementation of essential micronutrients may be needed in those IBD patients. Continued close guidance from dietitians and healthcare providers would also be needed by those IBD patients.

While the symptoms of diarrhea may remain unresolved, a low FODMAP diet can still be an effective way to manage overall IBD symptoms. For those with IBD, working with a registered dietitian who specializes in low FODMAP diets is the best way to ensure that all nutritional needs are being met.