Effectiveness of a low FODMAP diet and aerobic exercise in reducing epigastric symptoms among individuals with functional dyspepsia- A randomized controlled trial

Background: Recent studies recommended that addition of dietary modifications notably the low FODMAP (Fructo-Oligosaccharides, Di-, Monosaccharides, And Polyols) diet and regular aerobic exercise can provide effective symptom control in functional dyspepsia (FD).This study assessed the combined effects of low FODMAP diet and regular aerobic exercise on dyspeptic symptoms in patients with FD.Methods: This prospective randomized controlled trial was conducted among patients with FD where eligible participants were assigned in a 1:1 ratio to either the intervention group (a low FODMAP diet and a regular aerobic exercise along with conventional therapy) or the control group (conventional therapy alone) for 24 weeks.The Structured Assessment of Gastrointestinal symptom (SAGIS) score for assessing the gastrointestinal symptoms and the Short Form Nepean Dyspepsia Index (SF-NDI) for analyzing health-related quality of life (HRQOL) done at baseline, 12 and 24 weeks.Results: Overall, 70 patients were included in this study, 35 each in both arm with the mean standard deviation age of the patients was 43 10 years.At baseline, the mean SAGIS score for the intervention arm was 54 12.5 and the control arm was 50 10 where the scores were comparable between the two groups.After 12 weeks, there was a significant change in the epigastric symptoms from baseline between both arms was -3.571 1.044.Further, the mean difference of SAGIS score was -3.571 1.044 (90% confidence interval [CI] -5.668 to -1.475, P = 0.001) and SF-NDI of -12.086 1.394 (90% CI -14.892 to -9.280, P < 0.001).Thus, there was a statistically significant reduction in the SAGIS score and SF-NDI from baseline in the intervention arm when compared to the control arm (P < 0.05).Conclusion: The combination of a low FODMAP diet and regular aerobic exercise was effective in reducing epigastric symptoms and improved the quality of life among individuals with FD compared with conventional therapy alone.