The Low FODMAP Diet for Children with Inflammatory Bowel Disease and Overlapping Functional Gastrointestinal Symptoms - a Case Series

The low FODMAP diet (LFD) is a dietary intervention developed for and used particularly for the management of functional GI symptoms (FGIS) in adults with irritable bowel syndrome (IBS). It has also been proposed to improve coincident functional gut symptoms in adults with inflammatory bowel disease (IBD). This report describes the outcomes of the LFD in a series of children with IBD with concurrent FGIS. This study included children aged between 7-14 years with quiescent IBD and overlapping FGIS. All participants received three dietetic consultations in line with best practice recommendations. The IBS Global Improvement Scale was used to assess symptom outcomes. Mean (standard deviation [SD]) and number (percentage) were calculated for continuous and categorical data. Seven (77.7%) of the nine children experienced GI symptom improvement after completing the LFD for four weeks. All seven children had recurrence of symptoms in response to challenge with fructans and three also experienced symptoms of lactose intolerance. The LFD may be considered as a dietary option to help alleviate overlapping FGIS in children with quiescent IBD when provided by a qualified paediatric gastroenterology dietitian. Further studies are now required to support these findings.