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Diet in irritable bowel syndrome.

Magdy El-Salhy1,2,3, Doris Gundersen4

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Dietary changes, particularly reducing fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fiber, can significantly improve Irritable Bowel Syndrome (IBS) symptoms. This approach also positively impacts gut microbiota and endocrine cells, enhancing quality of life for IBS patients.

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Area of Science:

  • Gastroenterology
  • Dietary Science
  • Microbiome Research

Background:

  • Irritable Bowel Syndrome (IBS) is a prevalent chronic gastrointestinal disorder marked by abdominal pain, altered bowel habits, and bloating.
  • Current understanding suggests IBS symptoms are triggered by poorly absorbed carbohydrates like FODMAPs and insoluble fiber, not food allergies or gluten intolerance.

Purpose of the Study:

  • To review recent advancements in understanding the role of diet in IBS pathophysiology and management.
  • To clarify the relationship between diet, gut microbiota, and gastrointestinal endocrine function in IBS.

Main Methods:

  • Literature review focusing on recent developments in IBS pathophysiology and dietary management.
  • Analysis of the impact of fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fiber on IBS symptoms.
  • Examination of the effects of dietary interventions on gut microbiota and gastrointestinal endocrine cells.

Main Results:

  • A diet low in FODMAPs and insoluble fiber effectively reduces IBS symptoms and improves patient quality of life.
  • Dietary modifications favorably alter intestinal microbiota composition and restore abnormalities in gastrointestinal endocrine cells.
  • Non-coeliac gluten sensitivity (NCGS) appears to be self-diagnosed IBS patients reacting to wheat carbohydrates, not gluten.

Conclusions:

  • Reducing FODMAPs and insoluble fiber intake is a key dietary strategy for managing IBS.
  • Dietary interventions can positively influence the gut microbiome and restore hormonal regulation of appetite in IBS patients.
  • Individualized dietary guidance, probiotics, and exercise are recommended for comprehensive IBS management.