A1 Refereed original research article in a scientific journal
Low-FODMAP vs regular rye bread in irritable bowel syndrome: Randomized SmartPill (R) study
Authors: Laura Pirkola, Reijo Laatikainen, Jussi Loponen, Sanna-Maria Hongisto, Markku Hillilä, Anu Nuora, Baoru Yang, Kaisa M Linderborg, Riitta Freese
Publisher: BAISHIDENG PUBLISHING GROUP INC
Publication year: 2018
Journal: World Journal of Gastroenterology
Journal name in source: WORLD JOURNAL OF GASTROENTEROLOGY
Journal acronym: WORLD J GASTROENTERO
Volume: 24
Issue: 11
First page : 1259
Last page: 1268
Number of pages: 10
ISSN: 1007-9327
eISSN: 2219-2840
DOI: https://doi.org/10.3748/wjg.v24.i11.1259
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/30429621
AIMTo compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill (R).METHODSOur aim was to evaluate if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, different transit times, and fewer IBS symptoms than regular rye bread. The study was a randomized, double-blind, controlled cross-over meal study. Female IBS patients (n = 7) ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day. Intraluminal pH, transit time, and pressure were measured by SmartPill, an indigestible motility capsule.RESULTSHydrogen excretion (a marker of colonic fermentation) expressed as area under the curve (AUC)((0-630 min)) was [median (range)] 6300 (1785-10800) ppm.min for low-FODMAP rye bread and 10 635 (4215-13080) ppm.min for regular bread (P = 0.028). Mean scores of gastrointestinal symptoms showed no statistically significant differences but suggested less flatulence after low-FODMAP bread consumption (P = 0.063). Intraluminal pressure correlated significantly with total symptom score after regular rye bread (rho = 0.786, P = 0.036) and nearly significantly after lowFODMAP bread consumption (rho = 0.75, P = 0.052). We found no differences in pH, pressure, or transit times between the breads. Gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only during one measurement (out of 14 measurements in total) and therefore did not follow on par with the rye bread bolus.CONCLUSIONLow-FODMAP rye bread reduced colonic fermentation vs regular rye bread. No difference was found in median values of intraluminal conditions of the gastrointestinal tract.
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