Evidence map›Paper›PMID 39934502›Full record

ArticleEuropean journal of pediatrics2025

The low FODMAP diet in adolescents functional abdominal in a non-guided setting: a prospective multicenter cohort study.

Robyn Rexwinkel, Nicolaas Koen Vermeijden, Judith Zeevenhooven, Johannes Kelder, Michael Groeneweg, Thalia Hummel, Joery Goede, Herbert van Wering, Janneke Stapelbroek, Marc Benninga and 1 more

Abstract readMulticenter Study
In one paragraph

Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Robyn Rexwinkel *Emma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Room C2-312, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
Nicolaas Koen Vermeijden *Emma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Room C2-312, PO Box 22700, 1100 DD, Amsterdam, The Netherlands. n.k.vermeijden@amsterdamumc.nl.
Judith ZeevenhoovenEmma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Room C2-312, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
Johannes KelderDepartment of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
Michael GroenewegDepartment of Pediatrics, Maasstad Hospital, Rotterdam, The Netherlands.
Thalia HummelDepartment of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands.
Joery GoedeDepartment of Pediatrics, Spaarne Gasthuis, Haarlem, The Netherlands.
Herbert van WeringDepartment of Pediatrics, Amphia Hospital, Breda, The Netherlands.
Janneke StapelbroekDepartment of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands.
Marc Benninga *Emma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Room C2-312, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
Arine Vlieger *Department of Pediatrics, St Antonius Hospital, Nieuwegein, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The purpose of this study is to evaluate the efficacy of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) in adolescents with irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) in a non-guided setting, resembling clinical practice. This prospective multicenter cohort study conducted in 13 centers included patients aged 12-18 years diagnosed with IBS or FAP-NOS. Patients received educational material on FODMAPs, including extensive lists of high and low FODMAP foods and additional online information. They were instructed to replace high FODMAP foods with low FODMAP alternatives for the duration of 4 weeks. No dietician was consulted. The primary end point was the proportion of patients with treatment success (≥ 30% reduction of abdominal pain intensity) at 4 weeks. The key secondary outcome was adequate relief of IBS/FAP-NOS symptoms. Of the 325 included patients, 81 patients (24.9%) achieved treatment success (≥ 30% reduction of abdominal pain intensity) after 4 weeks, with higher rates in patients with IBS (29.3%) than FAP-NOS (16.8%, OR 2.16 (1.04-4.48)). Adequate relief was reported in 51 patients (15.7%). There was a significant decrease in abdominal pain intensity (2.2 (1.1) vs. 2.5 (1.0), P < 0.001), daily bloating (2.4 (2.1) vs. 2.8 (2.3), P < 0.001), and flatulence (2.4 (2.1) vs. 2.8 (2.3), P = 0.001). Adverse events were mild and infrequent.

conclusionThe low FODMAP diet in a non-guided setting, mimicking clinical practice, yielded treatment success in almost 30% adolescents with IBS and 17% in FAP-NOS, suggesting it may not be the first treatment option for these patients.

trial registrationEUCTR2015-003293-32-NL. WHAT IS KNOWN: • Irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) are common disorders in children which negatively impact quality of life. • While a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has demonstrated effectiveness in adult IBS, its efficacy in pediatric IBS and FAP-NOS remains uncertain. • Clinical application of the low FODMAP diet often occurs without dietician consultation, contrary to controlled trial settings. WHAT IS NEW: • The low FODMAP diet, without dietician guidance, resulted in treatment success in almost 30% of adolescents with IBS and only 17% with FAP-NOS. • With only 15.7% of participants achieving adequate relief of IBS/FAP-NOS symptoms, the non-guided low FODMAP diet may not be the first treatment option for pediatric IBS and FAP-NOS.

Indexed as

Abdominal PainDiet, Carbohydrate-RestrictedIrritable Bowel SyndromeAdolescentChildDisaccharidesFemaleFermentationFODMAP DietHumansMaleMonosaccharidesOligosaccharidesPolymersProspective StudiesTreatment OutcomeDisaccharidesMonosaccharidesOligosaccharidesPolymerspolyolChildrenFODMAPFunctional abdominal pain disorders

Identifiers

PMID39934502
PMCPMC11814023

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.