A pilot randomised controlled trial of the effect of a diet low in poorly digested carbohydrates on gastrointestinal form and symptoms in irritable bowel syndrome patients (CRAIGS)

1st December 2015 - ongoing

Status: In Recruitment

Specialism: Imaging, MR Imaging, Lower GI, Functional Bowel Disorder, Irritable Bowel Syndrome (IBS).

Team: Professor Robin SpillerDr Luca Marciani.

FODMAPs (Fermentable Oligosaccharide Disaccharide Monosaccharide and Polyols) are a group of poorly digested carbohydrates found in certain cereals, fruits, vegetables, and dairy products. They are poorly absorbed by the small intestine, being subsequently fermented by bacteria in the large intestine. This results in flatulence, bloating, diarrhoea and altered bowel habit in Irritable Bowel Syndrome (IBS) patients; nonIBS

sufferers rarely experience these symptoms. Some evidence suggests that reducing these dietary carbohydrates may relieve symptoms in IBS patients.

Consequently, the low FODMAP diet has been recommended by the National Institute for Health and Care Excellence (NICE) as dietary management for IBS patients with persistent symptoms following general dietary and lifestyle advice. However, other research suggests that a reduction of these carbohydrates through a low FODMAPs diet might affect large intestine bacterial growth. Therefore, understanding is sought of these ideas and any effect on the bowel. We aspire to study 40 IBS patients not previously on the low FODMAPs diet. Study participants will receive dietary intervention (low FODMAPs dietary advice); this will be given by the Principal Investigator, who is a registered dietitian.

Participants will be randomised into two groups: the first group receiving immediate intervention, the latter receiving delayed intervention. Both groups will be on the diet for 2 weeks, followed by dietary advice on reintroduction at different time points; a telephone follow-up will be scheduled after 3 months. Any changes to the bowel will be measured by MRI scans and breath tests; changes in symptoms will be recorded using symptom questionnaires during intervention. Additionally, dietary, quality of life and psychological information will also be collected using short questionnaires. A food diary will also be kept prior to and during intervention. The study will be conducted at the Nottingham Digestive Disease Centre, and is expected to last for 15 months.

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professor-robin-spiller Professor Robin Spiller Robin's main interest is in the pathophysiology of functional GI diseases, particularly focusing on the role of infection and inflammation and alterations in serotonin metabolism in the irritable bowel syndrome. He has twice edited the British Society of…
dr-luca-marciani Dr Luca Marciani I graduated in Physics at the University of Genoa in Italy. I then worked in Milan and London before joining the University of Nottingham, where I was awarded my PhD in Physics. Following a series of multi-disciplinary research contracts and Fellowships…
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