Effectiveness of the Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet for Patients With Irritable Bowel Syndrome Managed in Primary and Secondary Care: A Systematic Review and Meta-Analysis of Randomized Trials.
- 1Department of Family Medicine, Maternity and Children Hospital in Arar, Arar, SAU.
- 2College of Medicine, Northern Border University, Arar, SAU.
- 3College of Medicine, King Saud University, Riyadh, SAU.
Abstract
The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has emerged as a promising dietary intervention for managing irritable bowel syndrome (IBS) symptoms. We aimed to evaluate the effectiveness of the low FODMAP diet compared with various control conditions in adults with IBS. The pre-specified primary outcome was the Irritable Bowel Syndrome Symptom Severity Score, whereas adequate relief, abdominal pain, bloating, and quality of life (QoL) were the secondary outcomes. A systematic search identified English-language randomized controlled trials (RCTs) from inception through 20 May 2026 that compared the low FODMAP diet with control conditions in adults with IBS. Statistical analyses were performed using RevMan 5.4 (Cochrane Collaboration, London, UK), with treatment effects expressed as standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was quantified using the I² statistic, and random-effects models were used for the primary analyses, with fixed-effect sensitivity analyses when heterogeneity was low. Twenty-three RCTs, encompassing 2,164 participants (1,852 completers), were included. Compared with traditional dietary advice, the low FODMAP diet significantly reduced IBS symptom severity score (SMD: -0.71; 95% CI (-1.02, -0.40)), improved adequate relief (OR: 2.15; 95% CI (1.54, 3.01)), reduced abdominal pain (SMD: -0.35; 95% CI (-0.54, -0.16)), decreased bloating (SMD: -0.45; 95% CI (-0.75, -0.15)), and improved QoL (SMD: 0.48; 95% CI (0.27, 0.69)). Similar benefits were observed against habitual diet comparators. Compared with other active dietary interventions, the low FODMAP diet did not significantly improve IBS symptom severity, adequate relief, or QoL, although it did modestly improve bloating. The low FODMAP diet is an effective intervention for reducing global IBS symptoms and improving QoL compared with traditional dietary advice and habitual diet; however, it does not appear to offer greater benefit than other structured active dietary interventions, aside from this modest, comparator-independent improvement in bloating. These findings suggest that structured dietary intervention and dietary support may contribute substantially to symptom improvement beyond FODMAP restriction itself.
Related
- Synthesis of the Endogenous Non-Reducing End Heparan Sulfate Disaccharides for Newborn Screening and Diagnosis of Mucopolysaccharidosis types I and II
- Effectiveness of community-based care pathways and relapse prevention strategies in schizophrenia: a systematic review and bibliometric analysis
- Comparative Effectiveness of Tricyclic Antidepressants, Serotonin–Norepinephrine Reuptake Inhibitors, and Anticonvulsants for Diabetic Painful Neuropathy: A Systematic Review and Meta-Analysis
- Comparative effectiveness of acupuncture combined with rehabilitation for post-stroke hemiplegia: a systematic review and network meta-analysis
- Effectiveness of dynamic neuromuscular stabilization-based interventions for nonspecific low back pain: a systematic review and meta-analysis
BibTeX
@article{alenezi2026effectiveness,
title = {{Effectiveness of the Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet for Patients With Irritable Bowel Syndrome Managed in Primary and Secondary Care: A Systematic Review and Meta-Analysis of Randomized Trials.}},
author = {Mohamad Ahmad M Alenezi and Jana Fayez A Alfayez and Joud Mohammed B Alkhidhr and Amasi Saad M Alruwaili and Almaha Mansour M Alanazi and Imtinan Abdullah S Alqarni and Nawa Farhan M Alanazi and Amaal Fayez M Alenezi and Ruba Olum K Alshammari and Zuhaa Shaher Dhahawi Alanazi and Ghadah Dhiyab H Alanazi and Nouf Sami H Alanazi and Sarah Sultan A Alanazi and Aryam Hamdan Y Alanazi and Noor Gamal Abdelhamid Aly Mohamed},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117606},
url = {https://europepmc.org/article/MED/42997859},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effectiveness of the Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet for Patients With Irritable Bowel Syndrome Managed in Primary and Secondary Care: A Systematic Review and Meta-Analysis of Randomized Trials.
AU - Mohamad Ahmad M Alenezi
AU - Jana Fayez A Alfayez
AU - Joud Mohammed B Alkhidhr
AU - Amasi Saad M Alruwaili
AU - Almaha Mansour M Alanazi
AU - Imtinan Abdullah S Alqarni
AU - Nawa Farhan M Alanazi
AU - Amaal Fayez M Alenezi
AU - Ruba Olum K Alshammari
AU - Zuhaa Shaher Dhahawi Alanazi
AU - Ghadah Dhiyab H Alanazi
AU - Nouf Sami H Alanazi
AU - Sarah Sultan A Alanazi
AU - Aryam Hamdan Y Alanazi
AU - Noor Gamal Abdelhamid Aly Mohamed
PY - 2026
DA - 2026/10/07
JO - Cureus
DO - 10.7759/cureus.117606
UR - https://europepmc.org/article/MED/42997859
AB - The low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has emerged as a promising dietary intervention for managing irritable bowel syndrome (IBS) symptoms. We aimed to evaluate the effectiveness of the low FODMAP diet compared with various control conditions in adults with IBS. The pre-specified primary outcome was the Irritable Bowel Syndrome Symptom Severity Score, whereas adequate relief, abdominal pain, bloating, and quality of life (QoL) were the secondary outcomes. A systematic search identified English-language randomized controlled trials (RCTs) from inception through 20 May 2026 that compared the low FODMAP diet with control conditions in adults with IBS. Statistical analyses were performed using RevMan 5.4 (Cochrane Collaboration, London, UK), with treatment effects expressed as standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was quantified using the I² statistic, and random-effects models were used for the primary analyses, with fixed-effect sensitivity analyses when heterogeneity was low. Twenty-three RCTs, encompassing 2,164 participants (1,852 completers), were included. Compared with traditional dietary advice, the low FODMAP diet significantly reduced IBS symptom severity score (SMD: -0.71; 95% CI (-1.02, -0.40)), improved adequate relief (OR: 2.15; 95% CI (1.54, 3.01)), reduced abdominal pain (SMD: -0.35; 95% CI (-0.54, -0.16)), decreased bloating (SMD: -0.45; 95% CI (-0.75, -0.15)), and improved QoL (SMD: 0.48; 95% CI (0.27, 0.69)). Similar benefits were observed against habitual diet comparators. Compared with other active dietary interventions, the low FODMAP diet did not significantly improve IBS symptom severity, adequate relief, or QoL, although it did modestly improve bloating. The low FODMAP diet is an effective intervention for reducing global IBS symptoms and improving QoL compared with traditional dietary advice and habitual diet; however, it does not appear to offer greater benefit than other structured active dietary interventions, aside from this modest, comparator-independent improvement in bloating. These findings suggest that structured dietary intervention and dietary support may contribute substantially to symptom improvement beyond FODMAP restriction itself.
SN - 2168-8184
ER -