Irritable bowel syndrome (IBS) is a prevalent condition characterised by abdominal pain, gas, bloating, diarrhoea, and constipation, occurring in varying combinations and intensities. Treatment typically involves dietary recommendations, such as consuming smaller, more frequent meals and avoiding triggers like coffee, alcohol, and carbonated drinks. Medications may also alleviate gas, constipation, diarrhoea, bloating, or pain. In some cases, antidepressants are used to manage symptoms effectively.
A recent study published in The Lancet Gastroenterology & Hepatology compared three treatment approaches: two dietary interventions and one medication-based regimen. The study was conducted at Sahlgrenska University Hospital in Gothenburg and focused on adult patients with moderate to severe IBS symptoms.
Superior symptom relief through dietary adjustments was evident. The first group received traditional nutritional advice for IBS, emphasising changes in eating habits coupled with a low intake of fermentable carbohydrates, known as FODMAPs. These include lactose-containing products, legumes, onions, and grains, which ferment in the colon and can exacerbate IBS symptoms.
The second group followed a low-carbohydrate diet rich in protein and fats. The third group received optimised medication based on their most bothersome IBS symptoms. Each group comprised approximately 100 participants undergoing four-week treatment periods. Evaluation using a standardised IBS symptom scoring scale revealed compelling results.
Among those receiving traditional dietary advice and low FODMAP intake, 76% experienced significant symptom reduction. In the low-carbohydrate, high-protein and fat diet group, this figure was 71%, while in the medication group, 58% reported improvement.
Furthermore, all groups reported enhanced quality of life, reduced physical symptoms, and alleviated anxiety and depression symptoms. At a six-month follow-up, even after participants in the dietary groups had partially reverted to their previous eating habits, a substantial number continued to experience clinically meaningful symptom relief: 68% in the traditional nutritional advice and low FODMAP group and 60% in the low-carbohydrate diet group.
The study, led by Sanna Nybacka, Researcher and Dietician, Associate Professor Stine Störsrud, and Professor Magnus Simrén, all from Sahlgrenska Academy, University of Gothenburg, underscores the pivotal role of diet in managing IBS. It highlights the effectiveness of personalised treatment approaches and calls for further investigation into predictive factors for optimal treatment outcomes.
“In this study, we demonstrate the central role of diet in IBS treatment, alongside effective alternative therapies,” explains Sanna Nybacka. “Future research aims to refine personalised treatment strategies for IBS, identifying factors that may influence individual responses to different treatment modalities,” she concludes.
More information: Sanna Nybacka et al, A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARIBS): a single-centre, single-blind, randomised controlled trial, The Lancet Gastroenterology & Hepatology. DOI: 10.1016/S2468-1253(24)00045-1
Journal information: The Lancet Gastroenterology & Hepatology Provided by University of Gothenburg
