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The role of diet in irritable bowel syndrome: implications for dietary advice.

Journal of internal medicine
November 1, 2019
A Rej et al. (5 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the role of gluten-free diet (GFD) in managing irritable bowel syndrome (IBS) symptoms and compare its efficacy with other dietary therapies.

Results Summary

Several RCTs demonstrated benefits of a GFD in IBS, though the mechanism of action remains uncertain. The abstract highlights concerns about potential nutritional inadequacies and gut microbiota alterations with restrictive diets like GFD.

Population

Individuals with irritable bowel syndrome (IBS).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
traditional dietary advice
no change
efficacy
individuals with IBS
-
evidence base is variable
#1
fibre
neutral
efficacy
individuals with IBS
-
exploring the efficacy
#2
low FODMAP diet
increase
efficacy
individuals with IBS
-
demonstrating the efficacy
#3
long-term 'adapted' low FODMAP diet
neutral
efficacy
individuals with IBS
-
emerging data
#4
gluten-free diet (GFD)
increase
benefits
individuals with IBS
-
showing the benefits
#5
restrictive diets - such as the low FODMAP and GFD
increase
nutritional inadequacies
individuals with IBS
-
may promote
#6
restrictive diets - such as the low FODMAP and GFD
increase
disordered eating behaviours
individuals with IBS
-
may promote
#7
restrictive diets - such as the low FODMAP and GFD
decrease
gut microbiota
individuals with IBS
-
lead to detrimental alterations
#8
Abstract

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects approximately 10% of the population. Diet triggers symptoms in the vast majority of individuals with IBS. In view of this, there has been a focus on the role of diet in IBS. The diets currently being headlined for IBS include (i) traditional dietary advice, (ii) the low fermentable oligo-, di-, mono- saccharides and polyols (FODMAPs) diet and (iii) the gluten-free diet (GFD). Although traditional dietary advice is considered as the first-line dietary therapy, its evidence base is variable, with a few randomized controlled trials (RCTs) exploring the efficacy of this approach, other than for fibre. There are now a growing number of RCTs demonstrating the efficacy of the low FODMAP diet in the short-term, with some emerging data on the long-term 'adapted' low FODMAP diet. There are also several RCTs showing the benefits of a GFD in IBS; however, this concept is hampered with uncertainty as to the mechanism of action. Nevertheless, all of these dietary therapies are viable options for individuals with IBS, with the dietitian and patient engagement at the forefront of achieving success. However, future pragmatic studies are needed to clarify the comparative efficacy and convenience of implementing these various diets into routine life. Moreover, it is imperative to better delineate the concern that restrictive diets - such as the low FODMAP and GFD - may promote nutritional inadequacies, disordered eating behaviours, and lead to detrimental alterations to the gut microbiota.

Medical Subject Headings (MeSH)
DietHumansIrritable Bowel Syndrome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations37
Citations/Year6.2
Relative Citation Ratio2.27
NIH Percentile78.2%
Research Impact Scores
APT Score0.75
Weight Score2.38
Normalized Score0.66
Related Supplements
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