JMIR Publications

ABSTRACT

Background:

Irritable Bowel Syndrome (IBS) is a gastrointestinal functional disorder that affects around 11% of the global population [1]. Dietary management, particularly through low-fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (known as Low FODMAP), has proven to be an effective strategy for managing IBS and alleviating its symptoms [2]. Despite its clinical effectiveness [2], the complexity and restrictive nature of such diets can discourage individuals from adopting them [3]. Mobile health (mHealth) applications offer potential to support dietary self-management [4], but market review findings at the time of this study showed that most available apps lacked behavioural change features, symptom tracking, or structured reintroduction support, limiting their effectiveness for users with IBS.

Objective:

To design, develop, and assess the feasibility and usability of FODMAP Guru, a user-centred mHealth prototype intended to support adherence to the low-FODMAP diet and symptom self-management in individuals with IBS.

Methods:

A formative, mixed-methods study was conducted. (1) A literature and market review of 49 low-FODMAP related mHealth apps used PRISMA screening and the Health-ITUES evaluation tool [5] to identify functional gaps. (2) Semi-structured interviews with adults diagnosed with IBS explored user needs; transcripts were analysed thematically using NVivo. (3) Following Double Diamond [6] co-design principles, iterative low- and high-fidelity prototypes were produced. (4) Feasibility testing with new participants (n = 7) employed the System Usability Scale (SUS) [7], task-completion observations and open-ended feedback. Quantitative data were summarised descriptively; qualitative feedback was coded inductively.

Results:

The literature and market review strategy identified significant gaps in existing mHealth apps for IBS, particularly in usability, personalised dietary management, symptom tracking, healthcare professional engagement, and the provision of reliable, evidence-based educational content. The “FODMAP Guru” prototype was developed as a potential solution, informed by a user-centred design approach and iterative co-design process. Semi-structured interviews with adults diagnosed with IBS (n = 4; 75% female; mean age = 42.8 ± 13.5 years) highlighted the need for structured symptom tracking, meal planning support, and accessible education. Thematic analysis revealed four core themes: User Experience and Preferences, Health Management Practices, Desired Features for FODMAP Guru, and Challenges with Current mHealth Apps. Each theme was informed by multiple participants. These user-centred design approaches and iterative co-design processes led to the development of the “FODMAP Guru” prototype. Usability testing (n = 7) of the prototype yielded a mean System Usability Scale (SUS) score of 91.8 ± 6.5, indicating excellent usability. Participants reported that the app was easy to navigate, helpful, and likely to support adherence to the low FODMAP diet.

Conclusions:

This formative study shows that FODMAP Guru is a feasible and highly usable digital tool that addresses key limitations in existing low-FODMAP diet applications. These early findings highlight the value of user-centred and co-designed mHealth interventions in supporting not only adherence to the low-FODMAP diet, but also dietary self-management more broadly. Larger-scale studies are needed to evaluate its long-term impact on symptom management, dietary adherence, and quality of life.