February 2, 2023

New study investigates low-FODMAP diet for IBS in remission of IBD

Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

Approximately 30% with IBD have irritable bowel syndrome (IBS). Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to study published six weeks ago in Nutrients, researchers investigated the effectiveness of a low-FODMAP diet in patients that meet the criteria for IBS in IBD remission.

Previous research has demonstrated the impact of diet on inflammatory bowel disease (IBD). Diets such as low FODMAP and specific carbohydrate diet (SCD) have effective in patients with IBD, whereas pro-inflammatory, western diets have been associated with IBD pathogenesis.

FODMAPs act as prebiotics and modulate the gut microbiome by stimulating the growth of beneficial bacteria and promoting the production of short-chain fatty acids, so a low-FODMAP diet might be characterized as anti-prebiotic because of its reduction in beneficial bacteria species.

This study included 59 patients that followed a low-FODMAP diet for 6 weeks. Assessments included IBS diagnostic criteria, anthropometric measurements, laboratory tests and a lactulose hydrogen breath test. After the six-week period, IBS-like symptoms were not present in 66% of the participants. This included flatulence and diarrhea. The diet had no effect on constipation or IBD activity markers of inflammation including fecal calprotectin and CRP levels. This is most likely because these individuals were in remission and not in a current disease state with their IBD. In addition, the lack of improvement of constipation makes sense as this diet was reducing their intake of dietary fiber. As a result, this study demonstrates the beneficial effects of dietary interventions for patients with IBS symptoms.

The gastrointestinal tract is 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-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms.

There remains a large disconnect between the medical research and what is experienced visiting a doctor in everyday practice. The research demonstrates the significance nutrition and nutrients and their essential role in chronic disease states.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Wiecek M, Panufnik P, et al. Low-FODMAP Diet for the Management of Irritable BowelSyndrome in Remission of IBD. Nutrients 2022 Oct 29;14(21):4562.