September 25, 2021

New study demonstrates success of low FODMAP diet in IBS for long term treatment

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects. A low-FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) diet is not a new treatment. Most functional medicine practitioners often incorporate a low FODMAP diet for patients with IBS, however, many of the dietary recommendations have not been backed by clinical trials.

According to a new study published last week in Nutrients, researchers investigated the short and long term efficacy, nutritional adequacy, and long term acceptance of a low FODMAP in patients with IBS. The patients’ compliance and ability to identify food triggers was also evaluated.

This study included 41 patients with IBS were given low-FODMAP diet and after two months started to reintroduce foods and then were treated with an Adapted low-FODMAP diet for a 6 to 24 month follow up. At each follow up visit questionnaires and Biolectrical Impedance Vector Analysis (BIVA) were performed. As a result, the low-FODMAP diet was effective in controlling gastrointestinal symptoms both short and long term as well as improving quality of life, anxiety, and depression. In addition, the low-FODMAP diet improved the quality of life without affecting nutritional adequacy. It was also noted that the perception of trigger foods was significantly different between the baseline and after two months. As a result, the research team demonstrated that even if there were some problems of acceptability and adherence reported, an low-FODMAP is nutritionally adequate and efficacious in improving IBS symptoms long term.

Diet is the most effective means to returning balance within the gastrointestinal system. Some patients may need a combination of botanicals, enzymes, and probiotics to optimize the gastrointestinal environment. Certain diagnostic tests may also be beneficial, including stool testing as well as food antibody testing.

The gastrointestinal tract is considered to be the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammtory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains such as Saccharomyces cerevisiae CNCM I-3856 that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Bellini M, Tonarell S, et al. A Low-FODMAP Diet for Irritable Bowel Syndrome: Some Answers to the Doubts from a Long-Term Follow-Up. Nutrients, 7 August 2020, 12(8), 2360.

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