Dietary interventions and irritable bowel syndrome - what really works?
Study Goal
The researchers aimed to evaluate the evidence supporting the efficacy of a gluten-free diet in managing irritable bowel syndrome (IBS) symptoms.
Results Summary
The study found that the benefits of a gluten-free diet in IBS are likely due to the reduction of FODMAPs rather than gluten itself, suggesting limited direct efficacy of gluten elimination.
Population
Patients with irritable bowel syndrome (IBS).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
general dietary advice | neutral | - | all IBS patients | - | should be offered | #1 |
Psyllium supplementation | neutral | - | IBS with both constipation and diarrhea predominance | - | is recommended | #2 |
low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet (LFD) | decrease | IBS symptoms | - | - | beneficial effects | #3 |
FODMAPs that are well tolerated | neutral | - | - | - | should be reintroduced | #4 |
gluten-free diet | neutral | - | - | - | benefits observed | #5 |
Modulation of gut microbiota using probiotics | neutral | - | - | - | shows promising results | #6 |
prebiotics and synbiotics | neutral | role in IBS | - | - | additional evidence is also needed | #7 |
LFD | decrease | symptom control | - | - | beneficial effects | #8 |
probiotics | increase | gut health and function | - | - | seem to contribute | #9 |
PURPOSE OF REVIEW: The review examines the latest research on the use of dietary interventions in the management of irritable bowel syndrome (IBS) in order to understand what is the evidence supporting the efficacy of a dietary approach in this disorder. RECENT FINDINGS: A general dietary advice should be offered to all IBS patients. Psyllium supplementation is recommended in IBS with both constipation and diarrhea predominance. There is increasing evidence showing the beneficial effects of a low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet (LFD) on IBS symptoms. FODMAPs that are well tolerated should be reintroduced in daily diet, to increase acceptability of the diet, and limit potentially harmful effects. The benefits observed with the gluten-free diet seem determined by the reduction of FODMAPs rather than gluten. Modulation of gut microbiota using probiotics shows promising results, but there are unanswered questions regarding the optimal strains, dose and duration of treatment. Additional evidence is also needed for the role of prebiotics and synbiotics in IBS. SUMMARY: Food is both trigger of IBS symptoms and therapeutic tool. Recent studies demonstrated the beneficial effects of LFD on symptom control, as well as the role of probiotics, which seem to contribute to gut health and function.