Cutting back on certain types of food and eating more of others can relieve irritable bowel syndrome
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Two diets appear to be more effective than medication in treating irritable bowel syndrome (IBS), a trial has found.
One diet is designed to be low in “FODMAPs,” which are sugars and similar carbohydrates found in dairy products, wheat, and certain fruits and vegetables. The second is a less common approach to treating irritable bowel syndrome (IBS): an adapted low-carbohydrate diet that is high in fiber but low in all other kinds of carbohydrates (i.e., sugars and starches).
In a randomized trial, both diets improved symptoms better than standard drug treatment after four weeks.
IBS causes a puzzling array of symptoms, including diarrhea, constipation, bloating, and abdominal pain, which can fade or fade over time. The underlying cause of this condition is unknown.
The usual advice is to avoid common triggers such as caffeine, alcohol or spicy foods. People can also take symptomatic treatments, such as laxatives to treat constipation or medications to treat diarrhea.
If these measures don’t work, people can also try cutting out FODMAP-rich foods, which are thought to cause bloating and diarrhea because they tend not to be digested before reaching the colon. This promotes water retention in the colon and produces gas as the molecules are consumed by bacteria, causing bloating.
Sanna Nibaka She and her colleagues at the University of Gothenburg in Sweden wanted to see how a typical low-FODMAP diet compared to different low-carbohydrate eating methods while still getting plenty of fiber. In practice, this means eating foods high in fat and protein, such as meat and dairy, while sources of fiber include nuts, seeds, legumes and vegetables, such as cabbage.
The research team asked about 300 people with IBS to use one of three approaches: take medication based on symptoms or follow one of two diets. For the diet approach, people get free grocery delivery, along with detailed meal plans and recipes.
After one month, 76% of the low-FODMAP group reported significant reduction in symptoms, compared with 71% of the low-carb diet group and 58% of the medication group.
Surprisingly, Nybacka said, a low-carbohydrate, high-fiber diet (without excluding FODMAP-containing foods) was just as effective as a low-FODMAP approach. “We can’t provide any answers. It appears that changing carbohydrate content and lowering FODMAP intake may be beneficial.”
but Hazel Everett A professor at the University of Southampton in the UK said the effect would be better if the trial lasted longer. “The problem with many proposed diet regimens for IBS is that they are difficult to maintain long-term,” she says.
Participants were followed for up to six months, but those who initially received medication were also given dietary advice for the past five months.
One potential problem with the low-carbohydrate, high-fiber diet is that this group experienced a slight increase in blood cholesterol levels, Nibaka said. She said people should therefore seek advice from their doctor before adopting such a diet.
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