An Asian perspective on irritable bowel syndrome

Area of Science:

• Gastroenterology
• Dietary Science
• Epidemiology

Background:

• Irritable bowel syndrome (IBS) is a common chronic condition with evolving diagnostic criteria.
• The Rome IV criteria differ from Rome III, notably excluding abdominal discomfort.
• Asian consensus guidelines recommend including abdominal discomfort in IBS diagnosis.

Purpose of the Study:

• To review the impact of changing IBS diagnostic criteria.
• To evaluate the effectiveness of the low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet in Asian IBS patients.
• To discuss the applicability of the low FODMAP diet in the context of traditional Korean cuisine and explore complementary and alternative medicine.

Main Methods:

• Literature review of IBS diagnostic criteria evolution (Rome III vs. Rome IV).
• Analysis of studies on the low FODMAP diet's efficacy and microbial impact in Asian IBS populations.
• Examination of traditional Korean foods and their relationship with IBS symptoms.
• Review of existing research on complementary and alternative medicine for IBS in Asia.

Main Results:

• The low FODMAP diet has shown effectiveness in Western and recent Asian IBS studies.
• Traditional Korean foods, like kimchi, may not correlate well with IBS symptoms despite being FODMAP-rich.
• Research on traditional herbal medicines for IBS in Asia is limited by heterogeneity and small sample sizes.

Conclusions:

• The low FODMAP diet protocol needs careful consideration for IBS patients, particularly in Korea.
• Further large-scale, well-designed studies are necessary to validate complementary and alternative medicine treatments for IBS in Asian populations.