Abstract
BACKGROUND AND AIMS: Irritable bowel syndrome (IBS) is a highly prevalent and morbid condition that causes tremendous symptom burden, impacts quality of life, and generates substantial healthcare costs. Current therapies are challenging to utilize and do not provide relief to many patients, creating a clear need for new innovation. In this study, we assess the efficacy of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)-hydrolyzing digestive enzymes in controlling IBS symptoms. METHODS: We present a single-arm, open-label pre-post intervention cohort study among patients who purchased FODMAP-targeting enzymes online. Participants completed anonymous online surveys capturing demographics and symptom severity at baseline and 4-week follow-up. RESULTS: After 4 weeks using the FODMAP-targeting digestive enzyme blend, 78.0% (95% confidence interval [CI]: [69.7%, 84.5%]) reported improvements in bloating and flatulence, 75.0% (95% CI: [61.2%, 85.1%]) reported improvements in diarrhea (IBS-D only), 72.7% (95% CI: [51.9%, 86.9%]) reported improvements in constipation (IBS-C only), and 65.3% (95% CI: [56.3%, 73.2%]) reported improvements in abdominal pain. Significant improvements in overall IBS symptom severity were observed (P < .01). For specific IBS symptoms, the greatest improvements were seen in bloating and flatulence (P < .01) and abdominal pain (P < .01). Quality of life (P < .01), mental well-being (P < .01), and food avoidance behaviors (P < .01) all significantly improved as well. CONCLUSION: While further research is needed, this is a promising first report that enzymatic digestion may have the potential to decrease the burden of disorders of the gut-brain interaction, including IBS.