A Smartphone Application-Assisted Dietary Intervention Improves Symptoms of Irritable Bowel Syndrome, Quality of Life

Researchers evaluated the effects of a low FODMAP diet delivered via smart phone vs standard otilonium bromide treatment in patients with IBS.

The following article is a part of conference coverage from the Digestive Disease Week 2021 Annual Meeting , held virtually from May 21 to 23, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from DDW 2021.


A mobile-based smartphone dietary intervention was found to be superior to standard medical intervention for improving symptom severity among patients with irritable bowel syndrome (IBS). These findings were presented during the Digestive Disease Week annual meeting, held virtually, from May 21-23, 2021.

Patients (n=470) with IBS and general practitioners (n=69) were recruited for the DOMINO clinical trial. Patients were randomized to receive otilonium bromide (60 mg, 3 times/day) as supervised by 1 of the general practitioners or a fermentable oligo-, di-, mono-saccharides and polyols (FODMAP)-lowering diet administered through a smartphone application for 8 weeks. Symptoms were assessed by the IBS Symptom Severity Score (IBS-SSS) and IBS Quality of Life instrument (IBS-QoL).

Patients were aged mean 41±15 years, 76% were women, and 71% fulfilled the Rome IV criteria for IBS.

Successful response to treatment was found among 71% of the smartphone group and 61% of the standard care groups (P =.03). Response was higher among patients fulfilling the Rome IV criteria in both groups (77% vs 62%; P =.005), respectively.

At a 6-month follow-up, response was maintained by 74% of the intervention and 58% of the control groups (P <.001).

Compared with baseline, IBS-SSS scores increased among both the intervention (mean, 267±96 vs 188±109 points; P <.001) and standard care (mean, 267±100 vs 170±109 points; P <.001) cohorts. Symptom improvement was more pronounced among the smartphone group (P =.02).

Similarly, IBS-QoL was significantly changed from baseline (mean difference [MD], intervention: -8.07 points; P <.001 vs control: -7.34 points; P <.001) as were depression scores (MD, intervention: -1.36 points; P <.001 vs control: -1.09 points; P <.001) and somatization scores (MD, intervention: -1.80 points; P <.001 vs control: -1.31 points; P <.001).

Treatment response was associated with female sex (odds ratio [OR], 2.35; P =.04) among patients in the intervention arm and with higher somatization (OR, 1.21; P =.002) among patients in the standard care arm.

This study found that both standard care with otilonium bromide and a smartphone-based FODMAP-lowering diet significantly improved symptoms of IBS and quality of life. The maintenance of treatment response was greater among patients using the smartphone application.

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Carbone F, Van den Houte K, Besard L, et al. The DOMINO study: diet or medication in primary care IBS. Presented at: Digestive Disease Week Annual Meeting; May 21-23, 2021. Abstract 512.