Dietary interventions for IBD
Research type
Research Study
Full title
Fermentable Dietary Carbohydrates as Triggers of Functional Gut Symptoms in Patients with Inflammatory Bowel Disease
IRAS ID
141065
Contact name
Kevin Whelan
Contact email
Research summary
Inflammatory bowel disease (IBD) is a chronic relapsing remitting disease characterised by inflammation of the gut. A proportion of patients with IBD (between 35% and 57%) in remission also have a range of gut symptoms similar to those experienced in functional bowel disorders, e.g. irritable bowel syndrome (IBS), such as abdominal pain, bloating and diarrhoea. These symptoms are not associated with underlying inflammation of the disease, but may result in impaired quality of life (QOL) and functioning.
There is a growing evidence base for the use of a diet low in fermentable carbohydrates for the management of functional gut symptoms (FGS) in patients with IBS. There is also evidence that the improvement of these symptoms is specifically due to the restriction of individual fermentable carbohydrates and not due to a placebo effect or other dietary factors. There is preliminary evidence for the use of this diet in patients with IBD who have FGS whilst in remission, however, there have yet to be any randomised controlled trials published in this area. Restriction of these carbohydrates therefore has the potential to alleviate FGS in patients with IBD experienced outside of active disease, leading to a reduction in the need for unnecessary and inappropriate maintenance therapies and an improvement in QOL.
This study will aim to determine if patients are sensitive to individual fermentable dietary carbohydrates in a re-challenge study in 32 patients with symptom alleviation following a low fermentable carbohydrate diet. The study will be in the form of a re-challenge cross-over trial. Patients who have achieved symptomatic control on the low fermentable carbohydrate diet will receive drinks containing common dietary carbohydrates (i.e. fructans, galactooligosaccharides and sorbitol) and symptom response will be compared with a placebo glucose challenge. Re-challenge is the standard method of measuring food sensitivities in routine clinical practice.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
13/LO/1878
Date of REC Opinion
16 Jan 2014
REC opinion
Further Information Favourable Opinion