Poster : P-2 ; Low-FODMAP Formula Improves Diarrhea and Nutritional Status in Patients Receiving Enteral Nutrition

Background & Aims: Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed, short-chain carbohydrates that play an important role in inducing functional gut symptoms. A low-FODMAP diet improves abdominal symptoms in patients with inflammatory bowel disease and irritable bowel syndrome. However, there is no clinical intervention study for the effect of FODMAP content on gastrointestinal intolerance (GI) and nutritional status in patients receiving enteral nutrition (EN). Therefore, we investigated the effect of EN formulas containing different FODMAP contents on GI and nutritional status in patients receiving EN through the randomized, multicenter, double-blind, 14-day clinical trial. Methods: Eligible hospitalized patients receiving EN (n=95) from 10 hospitals in Busan and its environs were randomly assigned to three groups; 84 patients completed the trial (low-FODMAP EN, n=30; moderate-FODMAP EN, n=28; high-FODMAP EN, n=26). Anthropometric and biochemical parameters were measured; stool assessment was performed using the King’s Stool Chart and clinical definitions. Results: Baseline values were not significantly different among the three groups. After the 14-day intervention, diarrhea was significantly improved in the low-FODMAP group (73.3%) than in the moderate- (33.3%) and high-FODMAP (30.8%) groups (P=0.046). King’s Stool scores were significantly reduced in the low-FODMAP group compared with the other two groups (P＜0.05). BMI increased significantly in the low- and high-FODMAP groups over the course of the intervention (P＜0.05 for both), and showed a trend toward increasing in the moderate-FODMAP group (P＜0.10). Serum prealbumin increased significantly in all groups by day-14; by day-3, it had increased to the levels at day-14 in the low-FODMAP group. At day-14, serum transferrin had increased significantly in the moderate-FODMAP group. When subjects were classified by condition (unimproved, no-symptom, diarrhea-improved, and constipation-improved), BMI increased significantly in all groups except the unimproved. Prealbumin levels significantly increased in the diarrhea-improved group at day-3 and day-14, and in the constipation-improved group at day-14. Transferrin levels significantly increased in the diarrhea-improved group at day-14. Conclusion: Low-FODMAP EN may improve diarrhea, leading to improved nutritional status and facilitating prompt recovery from illness.