{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:58:32Z","timestamp":1784638712245,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence supporting the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet in paediatric irritable bowel syndrome (IBS) remains limited. Mechanisms underlying inter\u2010individual variability in dietary response in children are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare the clinical efficacy of a low FODMAP diet (LFD) versus a dietitian\u2010guided habitual diet (HD; standard FODMAP intake) in children with IBS and to identify faecal and urinary metabolomic signatures associated with treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010centre, randomised assessor\u2010blinded crossover trial. Children with Rome IV\u2010defined IBS underwent a 2\u2010week run\u2010in, followed by 14\u2009days of LFD or dietitian\u2010guided HD, a 2\u2010week washout, and crossover to the alternate diet. The primary outcome was treatment success (\u2265\u200950% reduction in abdominal pain; period\u2010specific baseline VAS). Secondary outcomes included IBS Severity Scoring System (IBS\u2010SSS), stool pattern, and metabolomic profiling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010six children (mean age 10.2\u2009years) completed the trial. Treatment success was achieved in 57.6% during LFD versus 30.3% during HD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), with the greatest benefit observed in children with severe baseline pain (VAS &gt;\u20095). LFD was associated with significant reductions in IBS\u2010SSS scores and bloating. Targeted SCFA analyses showed lower faecal acetic acid during LFD than during HD, while exploratory faecal and urinary volatilome analyses identified candidate features associated with response categories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this randomised crossover trial, a LFD improved abdominal pain and symptom severity in children with IBS, with the greatest benefit in those with severe baseline pain. Exploratory faecal and urinary metabolomic analyses identified candidate features associated with non\u2010response, warranting further validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT06618677\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70718","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:25:23Z","timestamp":1778660723000},"page":"1592-1604","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical trial: Efficacy of a Low\n                    <scp>FODMAP<\/scp>\n                    Diet in Paediatric Irritable Bowel Syndrome\u2014A Randomised Crossover Trial With Exploratory Metabolomic Analysis"],"prefix":"10.1111","volume":"63","author":[{"given":"Fernanda","family":"Cristofori","sequence":"first","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, Children's Hospital' Giovanni XXIII' University of Bari Aldo Moro  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Celano","sequence":"additional","affiliation":[{"name":"Department of Soil, Plant and Food Sciences University of Bari Aldo Moro  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa Nadia","family":"Dargenio","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, Paediatric Section, Children's Hospital' Giovanni XXIII' University of Bari Aldo Moro  Bari 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