Implementation of low FODMAP-based dietary therapy combined with zero waste principles in the management of IBS – case study

Maja Agata  Kozłowska; Joanna Wyka

doi:10.12873/454kozlowska

Autores/as

Maja Agata Kozłowska Wrocław University of Environmental and Life Sciences, Faculty of Biotechnology and Food Science, Department of Human Nutrition https://orcid.org/0009-0004-6436-8063
Joanna Wyka Wrocław University of Environmental and Life Sciences, Faculty of Biotechnology and Food Science, Department of Human Nutrition

DOI:

https://doi.org/10.12873/454kozlowska

Palabras clave:

Irritable Bowel Syndrome; FODMAP Diet; Diet Therapy; Case Reports; Sustainable Development

Resumen

Introduction: Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain, bloating, and altered bowel habits. The low FODMAP diet (Fermentable oligosaccharides, disaccharides, monosaccharides and polyols) is one of the most documented dietary interventions in IBS, though its application may be limited by psychological and economic factors. Objectives: To evaluate the effectiveness of a personalized nutritional intervention based on the low FODMAP diet, considering both patient-centered needs and food waste reduction. Material and Methods: A 26-year-old female patient with IBS diagnosed according to Rome IV criteria was studied using a case study design. Symptoms were assessed with the Gastrointestinal Symptom Rating Scale (GSRS), dietary-health interviews, and body composition measurements by bioelectrical impedance. The intervention lasted seven months and followed three phases of the low FODMAP protocol, incorporating psychological support and the zero-waste concept. Results: A significant improvement was observed, with gastrointestinal symptoms reduced and quality of life enhanced. The mean GSRS score decreased from 6.0 to 1.9 points. Although statistical analysis was not applicable due to the single-case design, the observed change (average reduction of 4.1 points) suggests clinical relevance. Discussion: Evidence from meta-analyses and randomized trials supports the low FODMAP diet in reducing IBS symptoms. At the same time, this dietary approach requires individualization and professional supervision, as it may limit dietary diversity and contribute to psychological burden. Conclusions: Personalized dietary therapy based on low FODMAP principles may be effective in managing IBS, particularly when combined with nutritional education and an eco-friendly approach. The results are consistent with current literature supporting the efficacy of the low FODMAP diet in reducing IBS symptoms. An additional advantage of this intervention was integrating the zero-waste principle, which positively impacted both the patient’s economic situation and nutritional awareness. Keywords: IBS; FODMAP Diet; Diet Therapy; Case Reports; Sustainable Development

Referencias

1. Gajewski P, editor. Interna Szczeklika. 10th ed. Kraków: Medycyna Praktyczna; 2019.

2. Stróżyk M. Dietoterapia zespołu jelita drażliwego. Warszawa: PZWL; 2023.

3. Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP diet improves irritable bowel syndrome symptoms: a meta-analysis. Nutrients. 2017: 26;9(9):940. DOI: https://doi.org/10.3390/nu9090940

4. Monash University. Research at Monash University. [Internet]. Available from: https://www.monashfodmap.com/about-fodmap-and-ibs/ [cited 2024 Jul 20].

5. Monash University. Monash FODMAP Diet App [Internet]. Available from: https://apps.apple.com/pl/app/monash-fodmap-diet/id586149216?l=pl [cited 2024 Jul 20].

6. Zborowski M, Mikulec A, Wygoda M, Wojtas Z, Magiera A, Kruczek K. Straty i marnowanie żywności - charakterystyka problemu oraz sposoby przeciwdziałania skali zjawiska. Innowacje w Pielęgniarstwie i Naukach o Zdrowiu [online]. 2024 Dec 30: 9(4), 107-113. Available from: https://apcz.umk.pl/IWPNZ/article/view/58508 [cited 2024 Nov 25] DOI: https://doi.org/10.21784/IwP.2024.024

7. Kampania 17 Celów. Cel 12: Odpowiedzialna konsumpcja i produkcja [Internet]. Available from: https://kampania17celow.pl/cel-12-odpowiedzialna-konsumpcja-i-produkcja/ [cited 2024 Jul 30].

8. Pietzsch N, Ribeiro JLD, de Medeiros JF. Benefits, challenges and critical factors of success for Zero Waste: a systematic literaturę review. Waste Manag. 2017;67:324-353. DOI: https://doi.org/10.1016/j.wasman.2017.05.004

9. Bajana S, Beltrán T, Peñafiel D. Educación nutricional durante la alimentación enteral en domicilio de un caso con Síndrome de Wolf Hirschhorn en Ecuador. Nutr Clín Diet Hosp. 2020;40(2):181-187. DOI: https://doi.org/10.12873/402bajana

10. Pietrzak A, Skrzydło-Radomańska B, Mulak A, Lipiński M, Małecka-Panas E, Reguła J, et al. Rekomendacje diagnostyczno-terapeutyczne w zespole jelita nadwrażliwego. Gastroenterology Rev. 2018;13(4):167-96. DOI: https://doi.org/10.5114/pg.2018.78343

11. Varjú P, Farkas N, Hegyi P, Garami A, Szabó I, Illés A, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies. PLoS One. 2017;9(3):289. DOI: https://doi.org/10.1371/journal.pone.0182942

12. van Lanen AS, de Bree A, Greyling A. Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis. Eur J Nutr. Sep 2021; 60(6):3505-3522. DOI: https://doi.org/10.1007/s00394-020-02473-0

13. Algera JP, Demir D, Törnblom H, Nybacka S, Simrén M, Störsrud S. Low FODMAP diet reduces gastrointestinal symptoms in irritable bowel syndrome and clinical response could be predicted by symptom severity: a randomized crossover trial. Clin Nutr. 2022 Dec; 41(12):2792-2800. DOI: https://doi.org/10.1016/j.clnu.2022.11.001

14. Van den Houte K, Colomier E, Routhiaux K, Mariën Z, Schol J, Van den Bergh J, et al. Efficacy and findings of a blinded randomized reintroduction phase for the low FODMAP diet in irritable bowel syndrome. Gastroenterology. 2024 Jul;167(2):333-342. DOI: https://doi.org/10.1053/j.gastro.2024.02.008

15. Zahedi MJ, Behrouz V, Azimi M. Low fermentable oligo-di-mono-sac charides and polyols diet versus general dietary advice in patients with diarrhea predominant irritable bowel syndrome: A randomized controlled trial. J Gastroenterol Hepatol. 2018 Jun; 33(6):1192-1199. DOI: https://doi.org/10.1111/jgh.14051

16. Rexwinkel R, Vermeijden NK, Zeevenhooven J, Kelder J, Groeneweg M, Hummel T, et al. The low FODMAP diet in adolescents with functional abdominal symptoms in a non-guided setting: a prospective multicenter cohort study. Eur J Pediatr. 2025 Feb 11;184(2):189. DOI: https://doi.org/10.1007/s00431-025-05999-9

17. Bonakdar RA, Sweeney MM, Garvey C, White AA, VanNoord MU. Case report: initial successful treatment of migraine and irritable bowel syndrome with a low-FODMAP diet. J Am Nutr Assoc. 2024 May-Jun;43(4):339-344. DOI: https://doi.org/10.1080/27697061.2023.2288081

18. Nybacka S, Kinnander A, Augustin H, Bärebring L. Perceived healthiness of foods, food avoidance and diet-related anxiety in individuals with self-reported irritable bowel syndrome: a cross-sectional study. BMC Nutr. 2024 Oct 10;10(1):134. DOI: https://doi.org/10.1186/s40795-024-00945-8