Abstract:
Background: There is a lack of high quality evidence on the effectiveness of dietary interventions
on childhood recurrent abdominal pain (RAP). Fat is well known to affect gastrointestinal motility,
but to date no studies have evaluated the value of low fat diets in RAP.
Methods: Forty two children with functional RAP [19 (45.2%) males, 5-15 years] were recruited
after electrogastrography (EGG), gastric emptying (GE), antral motility and oro-caecal transit
(OCT) studies. Subjects were randomly allocated to low fat diet (group 1) and normal diet (group
2). Dietary instructions were provided in a diary and during an interview and energy and fat
intake were recorded. Patients consumed allocated diet for 4 weeks. They were assessed before
intervention and at 4 weeks using global seven-point scales for severity of symptoms and changing
symptoms.
Results: At one month, 12 (57.1%) patients in group 1 and 13 (61.9%) in group 2 had improvement
of symptoms (P=0.759). The average scores obtained for pain severity, change in symptoms and
frequency of episodes were not different between two groups (P=0.62). More patients with delayed
GE had improvement in symptoms [9 (82%)] following a low fat diet compared to those with
normal GE and OCT [3 (30%)] (P=0.024, power of the study 86%, at significant level of 0.05).
Conclusions: Low fat diet seems to be beneficial for the subgroup of functional RAP children
with delayed gastric emptying and intestinal transit while it has no significant therapeutic effect on
patients with normal gastrointestinal motility.
