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

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

The mean age of the study participants was 41±15 years, 76% were women, and 71% fulfilled the Rome IV criteria for IBS.

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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 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 greater among women (odds ratio [OR], 2.35; P =.04) in the intervention arm and with higher somatization (OR, 1.21; P =.002) among patients in the standard care arm.

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


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.

This article originally appeared on Gastroenterology Advisor