Trial reportThe American journal of clinical nutrition2022
Fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs), but not gluten, elicit modest symptoms of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial.
Trial report in The American journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03653689 (Molecular Phenotyping of IBS Subtypes), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Molecular Phenotyping of IBS Subtypes
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Gluten restriction in irritable bowel syndrome, yes or no?: a GRADE-assessed systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Exploration of differential responses to FODMAPs and gluten in people with irritable bowel syndrome- a double-blind randomized cross-over challenge study.Metabolomics : Official journal of the Metabolomic Society · 2024Trial
- Trial
- The Potential of Complementary and Alternative Therapies in Improving Diarrhea-Predominant Irritable Bowel Syndrome: Strategies for Long-Term Efficacy.Digestive diseases and sciences · 2026Review
- Article
- Advances in the mechanism of low FODMAP diet in the treatment of irritable bowel syndrome: a review.Frontiers in nutrition · 2026Review
- Implementing a Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet in Asia: Addressing Cultural, Clinical and Practical Challenges.Journal of neurogastroenterology and motility · 2025Review
- Characteristics of Hospitalized Patients With and Without Celiac Disease on a Gluten-Free Diet.Digestive diseases and sciences · 2024Article
- Probiotics and Prebiotics for the Treatment of Irritable Bowel Syndrome-A Narrative Review.Journal of clinical medicine · 2024Review
- The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review.Cureus · 2024Review
- Management of irritable bowel syndrome: a narrative review.Translational gastroenterology and hepatology · 2024Review
- Microbial inulinase promotes fructan hydrolysis under simulated gastric conditions.Frontiers in nutrition · 2023Article
- FODMAPs-Do they really affect IBS symptoms?Frontiers in medicine · 2023Article
- Diet and irritable bowel syndrome: an update from a UK consensus meeting.BMC medicine · 2022Article
- Modulating the gut microenvironment as a treatment strategy for irritable bowel syndrome: a narrative review.Gut microbiome (Cambridge, England) · 2022Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIrritable bowel syndrome (IBS) has been associated with diets rich in fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs), and gluten. Most previous studies have been single-blind and have focused on the elimination of FODMAPs or provocation with single FODMAPs. The effect of gluten is unclear, large trials isolating the effect of gluten from that of FODMAPs are needed.
objectivesThe aims of this study were to ensure high intakes of a wide range of FODMAPs, gluten, or placebo, and to evaluate the effects on IBS symptoms using the IBS-severity scoring system (IBS-SSS).
methodsThe study was carried out with a double-blind, placebo-controlled, randomized 3-way crossover design in a clinical facility in Uppsala from September 2018 to June 2019. In all, 110 participants fulfilling the IBS Rome IV criteria, with moderate to severe IBS, were randomly assigned; 103 (90 female, 13 male) completed the trial. Throughout, IBS participants maintained a diet with minimal FODMAP content and no gluten. Participants were block-randomly assigned to 1-wk interventions with FODMAPs (50 g/d), gluten (17.3 g/d), or placebo, separated by 1-wk washout. All participants who completed ≥1 intervention were included in the intention-to-treat analysis.
resultsIn participants with IBS (n = 103), FODMAPs caused higher IBS-SSS scores (mean 240 [95% CI: 222, 257]) than placebo (198 [180, 215]; P = 0.00056) or gluten (208 [190, 226]; P = 0.013); no differences were found between the placebo and gluten groups (P = 1.0). There were large interindividual differences in IBS-SSS scores associated with treatment. No adverse events were reported.
conclusionIn participants with IBS, FODMAPs had a modest effect on typical IBS symptoms, whereas gluten had no effect. The large interindividual differences in responses to the interventions warrant further detailed studies to identify possible underlying causes and enable individual prediction of responses. This trial was registered at www.clinicaltrials.gov as NCT03653689.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.