Little evidence exclusion diets reduce IBS symptoms

Last Updated: 2018-08-02

By Reuters Staff

NEW YORK (Reuters Health) - There is too little data to recommend a gluten-free diet (GFD) for reducing symptoms of irritable bowel syndrome (IBS), according to a new systematic review.

"Very low quality evidence" supports restricting intake of highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP) to ease IBS symptoms, Dr. Paul Moayyedi of McMaster University in Hamilton, Canada, and his colleagues also report.

Both GFD and low FODMAP diets have been recommended for IBS patients, with the latter being the most widely adopted, Dr. Moayyedi and his team write in the American Journal of Gastroenterology, online July 26.

They reviewed two randomized controlled trials of GFDs, including a total of 111 participants, and seven RCTs of low FODMAP diets in 397 participants.

In the GFD trials, patients who had responded to gluten restriction were randomized to continue their normal diet or have their meals "spiked" with gluten. Patients given extra gluten were more likely to see their symptoms worsen, although the difference when the two studies were pooled did not reach statistical significance.

Patients on a low-FODMAP diet were more likely to have a reduction in their global symptoms than those who consumed other diets, but some studies did not have statistically significant results.

Based on GRADE criteria, data quality overall was "very low," the authors state. "More data are needed, but of the available dietary interventions, a low FODMAP diet currently has the greatest evidence for efficacy in IBS."

Dr. Moayyedi was not available for an interview by press time.

SOURCE: https://bit.ly/2KkMli8

Am J Gastroenterol 2018.