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 Case Studies

Expert clinicians share real-life patient cases and outcomes 

Presented by Niki Strealy,
RDN, LD

The Diarrhea Dietitian

Case Study #1: Traditional Low FODMAP Diet with FODZYME

 Patient History and Assessment

  • 39 yo female w/ history of H pylori and gastric ulcers from an early age. Also with depression and anxiety that is managed with medications. Experienced many UTIs in early 20s that resulted in many courses of antibiotics.

  • Developed new onset of severe diarrhea in mid 30's after psychiatric medication changes.

  • Followed low FODMAP diet for three months. Was unable to tolerate any FODMAP challenges during reintroduction phase.

  • Shortly after failing low FODMAP reintroduction phase, was also diagnosed with SIBO. Treated with antibiotics for SIBO (Xifaxan) but remained SIBO positive for several months. Treated with a second round of Xifaxan and added on herbal treatments for SIBO.
  • Missed eating out with friends and family at restaurants or her friends' houses.
 Approach and Intervention

  • Guided through all three phases of low FODMAP diet (elimination, reintroduction, personalization.

  • During FODMAP reintroduction, learned biggest FODMAP triggers are fructans, especially wheat, garlic and onions.

  • Introduced FODZYME during Personalization phase, after SIBO treatment.

 Results and Outcome
  • Now successfully tolerates FODMAP triggers with FODZYME and can enjoy meals with friends and family without needing to prepare a separate meal. Appreciates the freedom FODZYME enables her not always eat low FODMAP.
High FODMAP Foods

Case Study #2: Expanding Social Options with FODZYME

 Patient History and Assessment

  • 79 year old female with history of binge eating, though no formal diagnosis of an eating disorder.

  • Experienced alternating diarrhea/constipation, bloating and GERD.

  • Diagnosed with SIBO, but was not treated for 6 months.

  • Poor candidate for low FODMAP diet due to history of disordered eating, elderly status and reliance on meals from outside of home for social and community engagement. 
 Approach and Intervention

  • Guided through all three phases of low FODMAP diet (elimination, reintroduction, personalization), but was unable to tolerate any FODMAP challenges.

  • Switched from psyllium to Sunfiber.

  • Treated for SIBO and shortly after started bingeing again.

  • Added FODZYME to allow her to socialize with friends and spend more time with her community.
 Results and Outcome

  • Still managing bingeing and bowel movements with diet, fiber and magnesium.

  • With FODZYME, she can now eat out with friends again and remain engaged in her social activities.

"I would tell people they've got nothing to lose! It's a great option for eating "normal" when you go on vacation, are traveling, or want to take a break from eating Low FODMAP. Occasionally I will have a mild reaction to taking it (abnomal BM's) but it's NOTHING compared to my usual symptoms. I can finally show up to holidays and parties and eat what everyone else is eating and not have to prepare myself a whole separate meal. It's been a life saver!"
FODZYME Patient
Patient and FODZYME user for 3 years

Presented by Jessie Wong,
MAcc, RDN, LD

The IBS Dietitian

Case Study #1: Traditional Low FODMAP Diet with FODZYME 

 Patient History and Assessment

  • Patient with IBS-C, experiencing bloating, pain, visceral sensitivity.

  • Followed low FODMAP diet by herself for 1 year but faced difficulties with how to reintroduce foods and conduct FODMAP challenges.

 Approach and Intervention

  • Focused on understanding where low FODMAP process had veered off course and how to implement low FODMAP diet as recommended.

  • Implemented a focused low FODMAP elimination phase as a quick reset then prioritized reintroduction of FODMAPs as soon as possible to learn triggers and tolerated portions.

  • Identified significant GOS intolerance and moderate fructan intolerance.

  • Introduced FODZYME® to open up her diet during personalization.

 Results and Outcome

  • Uses FODZYME® eat more diverse foods with less food fear and anxiety.

  • Now able to eat more high FODMAP foods and make meal choices with confidence.

High FODMAP Foods

Case Study #2: Simplified FODMAP Approach with FODZYME

 Patient History and Assessment

  • Patient with IBS-D, experiencing significant food fears.

  • History of trialing many elimination diets and protocols, though none provided consistent relief.

  • Conducted full dietary assessment and identified FODMAPs as likely digestive triggers.

  • Also considered at risk for disordered eating due to pre-existing food fears.

 Approach and Intervention

  • Implemented strategic FODMAP restrictions and swaps based on current diet to avoid excessive dietary restriction.

  • Narrowed in on fructan and GOS as biggest triggers based on response to targeted restrictions. 

  • Reintroduced FODMAPs group by group to learn tolerance thresholds.

  • Identified lactose and onion (fructan) as triggers is large quantities and introduced FODZYME to support tolerance.
 Results and Outcome
  • Now uses FODZYME to incorporate lactose and fructans into her diet and is able to eat high FODMAP foods with confidence and less worry of symptoms.
  • FZ- Stick Pack - Pasta
  • FZ -Restaurant
  • FZ-Italian-FE
  • FZ- Stick Pack - Pocket

FODZYME 101: Education for Healthcare Providers

How FODZYME helps patients manage symptoms like bloating, gas, diarrhea and constipation, plus best practices for usage and common FAQs

Read more on the HCP Blog

The latest research and guidelines on FODMAPs, digestive enzymes and how to improve clinical care for those with FODMAP intolerances