Programme no. 228-OP
Irritable Bowel Syndrome and Self-reported Food Intolerance in a Population of Giardia-exposed and Matched Controls
Sverre Litleskare*1, Kurt Hanevik2, Geir Egil Eide3, Knut Arne Wensaas4, Gudrun Elise Kahrs5, Guri Rørtveit6
1Research Unit for General Practice,Uni Research,Bergen,Norway, 2Institute of Medicine,University of Bergen,Bergen,Norway;National Centre for Tropical Infectious Diseases,Haukeland University Hospital,Bergen,Norway, 3Centre for Clinical Research,Haukeland University Hospital,Bergen,Norway, 4Research Unit for General Practice,Uni Research,Bergen,Norway;Department of Global Public Health and Primary Care,University of Bergen,Bergen,Norway, 5Department of Clinical Nutrition,Haukeland University Hospital,Bergen,Norway, 6Research Unit for General Practice,Uni Research,Bergen,Norway;Department of Global Public Health and Primary Care,University of Bergen,Bergen,Norway
* = Presenting author
Objectives: Are there differences between the Giardia exposed and the control group with regard to self-reported reactions to foods?
Do such differences vary according to IBS status in the two groups of participants?
Are there any differences between the groups regarding FODMAP-content of the reported foods?
Background: In 2004 there was an outbreak of giardiasis in Bergen, Norway. 1252 people had laboratory confirmed infection with the parasite Giardia lamblia. Three years later the group that suffered from giardiasis during the outbreak had an increased relative risk of irritable bowel syndrome (IBS) and chronic fatigue compared to a control group. The mechanisms for IBS are largely unknown, and several factors seem to be involved. The role of diet and reactions to foods has previously been investigated, with non-consistent results. A new and promising concept regarding diet is FODMAP, a group of carbohydrates found to aggravate symptoms in IBS-patients.
Results: Analyses are currently on-going. Patients who had giardiasis report more food intolerances than the controls. There are also statistically significant differences in subjective food intolerance between people with IBS and healthy individuals for many of the food-categories investigated. The association between food intolerance and FODMAP content is less obvious, but there is a trend towards more reported reactions to foods high in FODMAP.
Material/Methods: Mailed questionnaire to 1252 giardia-exposed individuals and 3598 matched controls three years after the Giardia-outbreak. The outcomes were IBS according to Rome III criteria and self reported food intolerance.
Conclusion: Patients who have had giardiasis and patients with IBS report more subjective food intolerance than their controls. The relation to FODMAP content needs further investigations before a conclusion can be made.
Points for discussion: Limitations: A low response rate in the control group may lead to bias of the results. The questionnaire part about food intolerance is not validated. Strenghts: This is a huge study, and the giardiasis group had laboratory confirmed exposure.