Su2076 Weight Regain After Roux-en-Y Gastric Bypass Surgery Is Associated With Dysphagia Symptoms but Not Manometric Findings

Abstract

Background: It has been suggested that a diet low in fermentable short chain carbohydrates, FODMAPs (Fermentable Oligo-Di-Monosaccharides and Polyols) can reduce gastrointestinal symptoms in patients with irritable bowel syndrome (IBS) (Gibson & Shepherd Am J Gastroenterol 2012). However, the intake of FODMAPs in IBS patients compared to the general population has not been studied. Aim: To measure the intake of FODMAPs in patients with IBS in comparison with the general population, and to determine the major sources of FODMAPs in the diet of IBS patients. Method: We included 115 patients with IBS according to the Rome III criteria (39.1±13.0 (mean± SD) years; 88 females) referred to our outpatient clinic. They completed a 4-days food registration record, which was compared with 115 age-and gender matched control subjects from a nation-wide dietary survey. A database including content of fructose, fructan, lactose, galacto-oligosaccharides (GOS) and polyols in 1700 food items was developed specifically for this study to determine the intake of FODMAPs. Results:The IBS patients had significantly lower intake of FODMAPs than the control group from the general population (30.91±14.3 vs.34.56±12.67 g/day; p,0.05). The intake of lactose was lower in IBS patients compared to controls (10.47±8.22) vs.13.70±8.29 g/day; p, 0.001), while polyol intake was significantly higher in the IBS group (1.70±1.87 vs.1.25±1.64 g/day; p,0.05). However, there were no statistically significant differences regarding the intake of fructose (14.18±7.63 vs.15.28±6.93 g/day; p=0.24) fructan (3.91±1.73 vs.3.78±1.67g/day; p=0.55) or GOS (0.63±0.61vs. 0.53±0.56 g/day; p=0.16) between IBS patients and control subjects. The major food sources with naturally occurring fructan and contributing to the intake of fructan in both groups were onion, garlic, wheat and rye. Fruit drinks/-juices and apples were the main contributors to the fructose intake. The richest sources of polyols in the IBS group were pears and sugar-free sweets and in the controls pears, apples and sugar-free sweets. Legumes and wheat-products were the major contributors to intake of GOS in both groups. IBS patients ate less dairy products and replaced 15% of lactose containing products with lactose-free, soy or oat products. The patients ingested half the amount of fruit drinks in comparison to the control group, and their intake of wheat containing food items was also lower than for the control group. Intake of legumes and onions were equal in both groups except for garlic that was more frequently consumed in the IBS group. Conclusion: Intake of FODMAPs seems to be lower in IBS patients than in the general population, and this was mainly explained by a reduction of the intake of lactose containing food items. Further studies assessing the role of intake of FODMAPs for symptoms in IBS patients are needed.