The role of diet in irritable bowel syndrome: implications for dietary advice
Open accessAbstract
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects approximately 10% of the population. Diet triggers symptoms in the vast majority of individuals with IBS. In view of this, there has been a focus on the role of diet in IBS. The diets currently being headlined for IBS include (i) traditional dietary advice, (ii) the low fermentable oligo‐, di‐, mono‐ saccharides and polyols (FODMAP s) diet and (iii) the gluten‐free diet (GFD). Although traditional dietary advice is considered as the first‐line dietary therapy, its evidence base is variable, with a few randomized controlled trials (RCT s) exploring the efficacy of this approach, other than for fibre. There are now a growing number of RCT s demonstrating the efficacy of the low FODMAP diet in the short‐term, with some emerging data on the long‐term ‘adapted’ low FODMAP diet. There are also several RCT s showing the benefits of a GFD in IBS; however, this concept is hampered with uncertainty as to the mechanism of action. Nevertheless, all of these dietary therapies are viable options for individuals with IBS, with the dietitian and patient engagement at the forefront of achieving success. However, future pragmatic studies are needed to clarify the comparative efficacy and convenience of implementing these various diets into routine life. Moreover, it is imperative to better delineate the concern that restrictive diets – such as the low FODMAP and GFD – may promote nutritional inadequacies, disordered eating behaviours, and lead to detrimental alterations to the gut microbiota.
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Issues with following a low FODMAP diet, as opposed to traditional dietary advice, include the need for a specialist dietitian to implement it, followed by close monitoring to avoid nutritional deficiencies or the development of overly restrictive eating habits.
“Issues with following a low FODMAP diet, as opposed to traditional dietary advice, include the need for a specialist dietitian to implement it, followed by close monitoring to avoid nutritional deficiencies or the development of overly restrictive eating habits.[207][208][209]”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [207]
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Introduction: Practices, Problems and Politics
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4 Gendering Drinking: Women as Subjects of Risk and Harm
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5 Intoxication, Addiction and the Racializing Biopolitics of Alcohol
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1 Creating Certainty: The Making of Low-Risk Drinking Guidelines
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3 Alcohol, Health and Wellbeing: Fear and the Imagining of Desirable Futures
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2 ‘Alcohol’s Harm to Others’: Stabilizing Research Objects and Expanding Regulation
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Conclusion: From Certainties to Contingencies
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- Authors
- Rej, A., Aziz, I., Tornblom, H., Sanders, D. S., & Simrén, M.
- Affiliations
- Royal Hallamshire Hospital (GB)
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Simrén, M.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2019-08-29
- Volume
- 286
- Issue
- 5
- Pages
- 490-502
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W2970952415
- Cited by
- 61
- References
- 81
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 8 · 2022: 10 · 2021: 18 · 2020: 11
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- onlinelibrary.wiley.com/termsAndConditions#vor (vor)
- Locations
- Journal of Internal Medicine (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, dietary therapy, low FODMAP diet, gluten-free diet, fibers, functional gastrointestinal disorders, nutritional adequacy, disordered eating, gut microbiota, dietitian role, patient engagement
- MeSH terms
- Diet, Humans, Irritable Bowel Syndrome
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