Author ORCID Identifier

https://orcid.org/0009-0007-6811-2462

Date of Award

Summer 6-24-2024

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Nutrition

First Advisor

Anita Nucci, PhD, RD, LD, FASPEN

Second Advisor

Molly Paulson, MS, RD, LD

Third Advisor

Abby Johnson, MS, RD, LD, CLT

Abstract

ABSTRACT

DIFFERENCE IN REPORTED SYMPTOMS BY TYPE OF MEDICAL NUTRITION THERAPY PROVIDED IN ADULTS WITH IRRITABLE BOWEL SYNDROME

By

Justina Kim

Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, affecting 9-23% of the population and characterized by abdominal pain related to bowel habits. Previous studies show that a low-FODMAP diet can reduce IBS symptoms. Emerging research is focusing on personalized dietary treatments like the Lifestyle Eating and Performance (LEAP) program, which uses the Leukocyte Activation Assay-Mediator Release Test (LAA-MRT) to identify foods causing inflammation. The effectiveness of MRT in improving IBS symptoms and quality of life remains uncertain. The aim of this study is to retrospectively analyze symptom reduction in adults with IBS who received either LEAP/MRT or low-FODMAP diet therapy.

Methods: This study involves a retrospective (observational) electronic medical record review of a convenience sample of adults aged 18 to 65 with IBS. Inclusion criteria include patients referred by a primary provider or gastroenterologist with an IBS diagnosis or symptoms consistent with IBS. Additionally, patients must have completed an initial symptom survey during their first visit and a follow-up survey within four weeks.

Results: Twenty-one adults diagnosed with IBS or with IBS symptoms were included in the study. Of these, 16 received LEAP/MRT therapy, while 5 were counseled on the low-FODMAP diet regimen. Participants in the LEAP/MRT group experienced a significant reduction in weight and BMI between the initial and 1-month follow-up visits (75.5 + 21.8 vs. 74.0 + 21.6 and 27.3 + 6.6 vs. 26.8 + 6.3, respectively; P<0.05). Statistically significant differences were observed within the LEAP/MRT group in multiple individual categories (constitutional, emotional, neurological, skin, nasal/sinus, mouth/throat, lung, eyes, ears, digestive, weight management) and in the total symptom score (86.5 [IQR: 59, 110] vs. 41 [IQR: 22, 60], respectively; P<0.001). Although the reported individual system symptoms were reduced at the follow-up visit for those in the Low-FODMAP group, the change in median scores over time was not statistically significant. However, the total median symptom score was significantly reduced at the follow-up visit (79 [IQR: 35, 132] vs. 22 [IQR: 10, 101.5], respectively; P=0.043).

Conclusion: We identified statistically significant reduction in the symptom summary scores between the initial and follow-up visits in multiple individual categories within the LEAP/MRT group. The LEAP/MRT approach may provide a personalized treatment option for individuals with IBS by addressing specific dietary sensitivities and enhancing patient outcomes. Additional research is needed to confirm these findings through larger, randomized, controlled trials and further solidify the clinical significance and long-term advantages of the LEAP/MRT intervention.

DOI

https://doi.org/10.57709/37341767

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