OP-16 DIETARY INTERVENTION USING THE LOW FODMAP DIET VERSUS THE "MILK, EGG, WHEAT AND SOYA FREE" DIET FOR TREATMENT OF FUNCTIONAL GUT DISORDERS A SINGLE CENTRE EXPERIENCE.

INTRODUCTION: The adolescent clinic is a tertiary referral clinic including patients with a wide variety of complex gastroenterology conditions predominantly tertiary referrals fromGreat Ormond Street Hospital transition clinic.

PURPOSE: To assess the benefit of the low FODMAP diet versus the "Milk, egg, wheat and soya" (MEWS) free diet for symptom control in patients with functional gut disorders and/or food allergy from June 2013 to June 2015.

METHODS: A total of 436 patients were seen during this time period for dietetic advice and the age range varied from 13-21 years old with 43terms of diagnosis used. These included the broad categories of inflammatory bowel disease, food allergy, functional gut conditions, congenital gut disorders, autoimmune disorders and oncology conditions. For functional gut disorders/food allergy there were 14 terms used which varied from "Functional gut disorder" to "Irritable bowel syndrome" and also included patients with delayed gastric emptying. For patients with food allergy the terms "multiple food allergy" or EosinophilicOesophagitis or Colitis were used. A total of 40 patients with functional gut disorders were referred for the MEWS or low FODMAP diet. The efficacy of the diet was measured using a symptom scale pre and post dietary intervention assessing if patients symptoms changed from nil/mild/moderate tosignificant. The results indicate whether the presenting predominant symptom e.g., bloating, constipation or abdominal pain improved following the dietary intervention.

RESULTS: A total of 29 patients were seen for the "MEWS" free diet.These were 17 functional, 3 food allergy, 6 IBS, 2 EosinophilicOesophagitis, 1 oncology patient. The age ranged from 14 to 21 and average ageat treatment was 16.6 years old with 11 males and 18 females. 13 patients were referred for the low FODMAP diet. The patients referred for the low FODMAP diet were 7 with a functional gut disorder, 5Irritable Bowel Syndrome and1 EosinophilicColitis.The age range was 14 to 19 years old with average age at treatment 16.3 years old. There were 6 males and 7 females. The success rate of the MEWS diet measured by reported significant improvement in predominant presenting symptom was 14/29 (48.2%),moderate 4/29 (13.7%) mild 2/29(6.9%) and 9/29 (31%) nil improvement. For the low fodmap diet 6/13 (46.1%) of patientsreported a significant improvement in symptoms,0/13 (0%) moderate,mild 2/13 (15.4%)and 5/13 (38.5%) had nil improvement.

CONCLUSIONS: This review suggests that although there were larger referral rates for the MEWS diet both the MEWS and low FODMAP diet appear to beequally effective dietary approaches for treating patients with functional gut disorders and/or food allergy.