Three widely followed diets for nonconstipated irritable bowel syndrome (IBS) produce similar results, but traditional dietary advice (TDA) is easier to follow, researchers say.
“We recommend TDA as the first-choice dietary option due to its widespread availability and patient friendliness,” Anupam Rej, MBChB, from Teaching Hospitals NHS Foundation Trust in Sheffield, England, and colleagues write.
AlexRaths/Getty Images
According to their study, about half the people following each of three diets – TDA; gluten-free; and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) – reported at least a 50% reduction in their symptoms.
They noted, however, that the low-FODMAP diet produced the most improvement in depression and dysphoria.
The study was published online in Clinical Gastroenterology and Hepatology.
What the dietary options entailed
The three diets have different origins and methodologies, but all are designed to reduce the abdominal pain, bloating, and altered bowel habits that characterize IBS.
TDA is based on recommendations of the UK National Institute for Health and Care Excellence and the British Dietetic Association. It includes “sensible eating patterns,” such as regular meals, never having too much or too little, and sufficient hydration. It calls for a reduction in alcoholic, caffeinated, and “fizzy” drinks; spicy, fatty, and processed foods; fresh fruit (a maximum of three per day); and fiber and other gas-producing foods, such as beans, bread, and sweeteners. It also asks people to address any perceived food intolerance, such as dairy.
In North America, the low-FODMAP diet is prescribed as first-line therapy, and the American College of Gastroenterology has given it a conditional recommendation.
FODMAPs are short-chain fermentable carbohydrates found in many fruits, vegetables, dairy products, artificial sweeteners, and wheat. They increase small intestinal water volume and colonic gas production that can induce gastrointestinal symptoms in people with visceral hypersensitivity.
People following the low-FODMAP diet start by eliminating all FODMAPs for 4-6 weeks, then gradually reintroducing them to determine which are most likely to trigger symptoms.
A gluten-free diet, inspired by what is prescribed to treat celiac disease, has gained popularity in recent years. Although researchers debate the mechanism by which this diet improves symptoms, one leading theory is a reduction in fructans that accompany gluten in foods such as bread.