P508 - ADADHERENCE TO A CUSTOMIZED LOW FODMAP DIET IN ASIAN PATIENTS WITH IRRITABLE BOWEL SYNDROME-DIARRHOEA

P508

ADADHERENCE TO A CUSTOMIZED LOW FODMAP DIET IN ASIAN PATIENTS WITH IRRITABLE BOWEL SYNDROME-DIARRHOEA

Y. C. Ng^1,*, J. Kuang¹, N. Chin², S. H. Wong^1,3

¹Gastroenterology and Hepatology, ²Nutrition and Dietetics, Tan Tock Seng Hospital, ³Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

Rationale: The Low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet (LFD) is effective in managing symptoms of IBS, however its adherence in Asian patients is poorly studied. This study aims to evaluate the adherence to the LFD in a group of Asian patients with IBS-D and elucidate barriers to adherence.

Methods: Adult patients fulfilling the ROME IV diagnostic criteria for IBS-D were recruited from the outpatient clinics at a tertiary hospital in Singapore and followed up for 28 days. All patients received advice on LFD at the initial visit from a trained dietitian using an educational pamphlet which included LFD food items customized to the palate of multi-ethnic Singaporeans. Adherence at Day 14 and 28 was evaluated by analysing the percentage of high FODMAP items avoided compared to baseline. A ≥75% avoidance was considered ‘adherent’, 50%-74% ‘partially adherent’ and <50% ‘not adherent’. The IBS-SSS (Symptom Severity Score) and IBS-QOL (Quality of Life) scores were obtained at Day 0 and 28. A qualitative questionnaire to assess barriers to LFD adherence was conducted at Day 28.

Results: We enrolled a total of 20 patients (11 females, median age 46.5 years, median BMI 22.6kg/m²).The mean adherence was 76.8% at Day 14 and 67.8% at Day 28 (p=0.04). There was a clinical improvement at Day 28 with a decrease in mean IBS-SSS scores from 228.2 to 167.1 (p=0.01) and an increase in mean overall IBS-QOL scores from 61.6 to 68.8 (p=0.01). Patients found it difficult and time-consuming to shop for LFD items. Also, the diet was unenjoyable and difficult to incorporate into their daily life.

Conclusion: A customised LFD advice by a dietitian is a useful adjunct in managing Asian IBS-D patients, however its adherence remains suboptimal. Challenges in sourcing for LFD items and palatability were major factors in barriers to adherence.

Disclosure of Interest: None declared