title: Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome.
abstract: Grains are high in FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols) and often considered as triggers of IBS symptoms.
  
  
  
  To evaluate if rye bread low in FODMAPs would be better tolerated than regular rye bread in subjects with IBS.
  
  
  
  The study was conducted as a randomised double blind controlled cross-over study (n = 87). Participants were supplied with both regular rye bread and low-FODMAP rye bread for 4 weeks. Symptoms were measured with a symptom severity scoring system (IBS-SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.
  
  
  
  Dietary fibre intake increased during both study periods compared to baseline. Many signs of IBS i.e. flatulence, abdominal pain, cramps and stomach rumbling were milder on the low-FODMAP rye bread (P-values: 0.04; 0.049; 0.01 and 0.001). The mean of VAS measurements was favourable towards LF bread [-3 (95% CI): -6 to -1, P = 0.02] but no differences were detected in IBS-SSS or quality of life. The AUC of breath hydrogen values was significantly lower during the low-FODMAP bread period (median 52.9 vs. 72.6; P = 0.01).
  
  
  
  Low-FODMAP rye bread helps IBS patients to control their symptoms and reduces gastrointestinal gas accumulation. However, replacing regular rye bread by low-FODMAP bread without concomitant broader dietary changes does not improve quality of life or IBS-SSS. Nonetheless, inclusion of low-FODMAP rye bread in diet might be one way that IBS patients could increase their fibre intake.
authors.affiliation: Faculty of Medicine, Department of Pharmacology, University of Helsinki, Helsinki, Finland.|Aava Medical Centre, Helsinki, Finland.
authors.forename: R
authors.identifier: 0000-0003-2907-0291
authors.initials: R
authors.lastname: Laatikainen
authors.affiliation: Aava Medical Centre, Helsinki, Finland.|Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Koskenpato
authors.affiliation: Fazer Bakeries Ltd, Vantaa, Finland.
authors.forename: S-M
authors.initials: SM
authors.lastname: Hongisto
authors.affiliation: Fazer Bakeries Ltd, Vantaa, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Loponen
authors.affiliation: STAT Consulting Ltd, Nokia, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Poussa
authors.affiliation: Aava Medical Centre, Helsinki, Finland.|Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Hillilä
authors.affiliation: Faculty of Medicine, Department of Pharmacology, University of Helsinki, Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Korpela
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy; D000328:Adult; D001939:Bread; D001944:Breath Tests; D018592:Cross-Over Studies; D004032:Diet / Q000379:methods*; D015930:Diet Records; D004187:Disaccharides / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005285:Fermentation; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009005:Monosaccharides / Q000008:administration & dosage; D009844:Oligosaccharides / Q000008:administration & dosage; D011108:Polymers / Q000008:administration & dosage; D011788:Quality of Life; D012434:Secale
chemical_list: D004187:Disaccharides; D009005:Monosaccharides; D009844:Oligosaccharides; D011108:Polymers; C024617:polyol