Do Patients with Irritable Bowel Syndrome Need a Specific Diet?


“IBS is a very complex disease involving many factors, but our results indicate that the effects of specific diets are not as great as previously thought,” explains Elise Nordin, PhD pupil in Food Science at Chalmers and lead writer of the scientific article, printed within the

IBS (irritable bowel syndrome) impacts round three to 5 p.c of the world’s inhabitants, and includes signs equivalent to abdomen ache, diarrhea and constipation.

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In the brand new research, which included 110 folks with IBS, the researchers examined how folks had been affected by serving them rice puddings ready in several methods.

One selection was wealthy in gluten whereas the opposite contained giant quantities of carbohydrate of the ‘fodmap’ selection – that’s, fermentable carbohydrates, together with sure chains of fructose and lactose. Many meals are wealthy in fodmaps, together with dairy merchandise, forms of bread and sure vegetables and fruit.

In addition to the specifically ready rice puddings, the researchers additionally served a impartial one which served as a placebo.

Double-blind information of the rice puddings

The contributors within the research ate rice puddings wealthy in fodmaps, gluten and the placebo in random order, for one week per class. The research was double-blind, that means neither the contributors nor the researchers knew who ate which rice pudding and when.

“Diet studies are difficult to conduct double blind, as it can often be obvious to the participants what they are eating. This is a big obstacle, as knowledge that something has been added to or removed from the diet can affect the result. The fact that we succeeded in creating diets that were completely blind, together with the large number of participants, makes our study unique,” says Elise Nordin.

The topics’ gastrointestinal methods had been provoked by excessive doses (1.5 occasions day by day consumption in a traditional inhabitants) of fodmaps or gluten. The fodmaps aggravated the signs, however to not the extent that the researchers had anticipated primarily based on outcomes from earlier research. Gluten, nevertheless, was discovered to haven’t any measurable detrimental impact on the topics’ perceived signs.

“Our results are important and indicate that the psychological factor is probably very important. IBS has previously been shown to be linked to mental health. Simply the awareness that one is being tested in a study can reduce the burden of symptoms,” says Per Hellström, Professor of Gastroenterology at Uppsala University who held medical duty for the research.

Distinguishing between the impact of gluten and fodmaps

In earlier research, researchers have primarily excluded fodmaps from the topics’ diets and this has proven a transparent discount in IBS signs. However, these research have had few contributors and haven’t been performed double-blind, which makes it troublesome to objectively consider the outcomes.

Many IBS sufferers exclude gluten from their food regimen, regardless of the shortage of scientific proof. Results from earlier analysis are inconsistent. Foods wealthy in gluten, equivalent to bread, are sometimes additionally wealthy in fodmaps – one principle has subsequently been that it’s the fodmaps in these meals, not the gluten, that causes the IBS signs. This exhibits the significance of research for separating the impact of fodmaps and gluten.

Examining how the food regimen will be individually tailored

The new research is a component of a bigger venture through which the researchers are in search of biomarkers within the intestinal flora or within the blood to have the ability to predict well being outcomes. The researchers wish to examine whether or not people will be divided into metabotypes – totally different teams primarily based on how people’ metabolism and intestinal flora reply to totally different diets, and whether or not these teams present totally different IBS signs.

“Finding objective biomarkers that can determine if an individual belongs to a certain metabotype for IBS symptoms could make life easier for many individuals with IBS. There are many indications that it is possible to use objective markers for more individually tailored dietary advice,” says Professor Rikard Landberg, who leads the Division of Food and Nutrition Science at Chalmers University of Technology.

The new IBS research additionally clearly exhibits giant particular person variation in terms of how totally different persons are affected by a particular food regimen.

“Even if at group level we only see a moderate effect from fodmaps and no effect of gluten provocation, it may well still be the case that some individuals react strongly to these foods. That is why it is important to account for individual differences,” says Elise Nordin.

More in regards to the research and fodmaps:

Fodmap is an abbreviation for ” Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols”. Examples of fodmaps are polymers of fructose, lactose, fructo/galacto-oligosaccharides and sugar alcohols, and they’re present in quite a lot of meals, equivalent to dairy merchandise, cereals, mushrooms and vegetables and fruit. Products which were sweetened with xylitol, for instance, are additionally wealthy in fodmaps.

The scientific research, ‘FODMAPs, however not gluten, elicit modest signs of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial’ was printed in The American Journal of Clinical Nutrition.

The authors of the article are Elise Nordin, Carl Brunius and Rikard Landberg of Chalmers University of Technology, and Per M Hellström, Uppsala University.

In the research, topics got excessive doses (1.5 occasions the conventional day by day consumption) of fodmaps (50 g) and gluten (17.3 g) and the outcomes had been in contrast with the placebo. Throughout the research, all topics ate a food regimen with in any other case minimal content material of fodmaps and no gluten. Each trial interval was one week, adopted by a one-week break. Blood and stool samples had been offered weekly as topics additionally accomplished questionnaires about their perceived signs.

The research was funded by Formas and the Swedish Research Council.

Source: Eurekalert

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