Dietary treatment is more effective than medication for irritable bowel syndrome, with more than seven out of ten patients significantly reducing symptoms
Irritable bowel syndrome (IBS) is a common diagnosis that causes abdominal pain, bloating and bloating, diarrhea, and constipation in various combinations and with varying degrees of severity.
Treatment usually consists of nutritional recommendations, e.g. B. eating small, frequent meals and avoiding excessive intake of trigger foods such as coffee, alcohol and soft drinks. Medication may also be given to relieve certain symptoms such as bloating or constipation, diarrhea, bloating, or abdominal pain. Antidepressants are sometimes used to relieve the symptoms of irritable bowel syndrome.
The current study, published in The Lancet Gastroenterology & Hepatology, compared three treatments: two dietary and one drug. Participants were adult patients with severe or moderate irritable bowel syndrome symptoms at Sahlgrenska University Hospital in Gothenburg.
Greater relief of symptoms after dietary changes
The first group received traditional nutritional advice for irritable bowel syndrome, focusing on eating patterns combined with low intake of fermentable carbohydrates, known as FODMAPs. These include, for example, products with lactose, legumes, onions and grains, which ferment in the large intestine and can cause pain in irritable bowel syndrome.
The second group received a diet treatment that was low in carbohydrates and relatively high in protein and fat. In the third group, the best possible medication was administered based on the patient’s most bothersome IBS symptoms.
There were approximately 100 participants in each group and treatment periods lasted four weeks. When researchers examined participants’ response to the treatments using an irritable bowel syndrome rating scale, the results were clear.
Of those who received traditional IBS diet recommendations and low FODMAPs, 76% significantly reduced symptoms. In the group that received few carbohydrates and a lot of protein and fat, the proportion was 71%, and in the medication group it was 58%.
All groups reported significantly better quality of life, fewer physical symptoms, and fewer symptoms of anxiety and depression.
The importance of personalization
At the six-month follow-up, when participants in the diet groups had partially returned to their previous eating habits, clinically significant symptom relief was still seen in a large proportion of participants; 68% in the traditional and low-FODMAP dietary advice group and 60% in the low-carbohydrate diet group.
The study was led by Sanna Nybacka, researcher and nutritionist, Stine Störsrud, associate professor, and Magnus Simrén, professor and senior advisor, all from Sahlgrenska Academy, University of Gothenburg.
“With this study we can show that diet plays a central role in the treatment of irritable bowel syndrome, but there are several alternative treatment methods that are effective,” says Sanna Nybacka.
“We need more knowledge about how to better personalize the treatment of irritable bowel syndrome in the future and will continue to investigate whether there are specific factors that can predict whether individuals respond better to different treatment options,” he concludes.
REFERENCE
A low-FODMAP diet plus traditional nutritional counseling versus a low-carbohydrate diet versus pharmacologic treatment in irritable bowel syndrome (CARBIS): a single-center, single-blind, randomized, controlled trial