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The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review.

Abstract

This review summarizes what is known about the effect of diet on irritable bowel syndrome (IBS) symptoms emphasizing data from randomized, controlled clinical trials. Studies suggest that IBS symptoms in one quarter of patients may be caused or exacerbated by one or more dietary components. Recent studies indicate that a diet restricted in fermentable, poorly absorbed carbohydrates, including fructose, fructans (present in wheat and onions), sorbitol, and other sugar alcohols is beneficial, but confirmatory studies are needed. Despite a long history of enthusiastic use, fiber is marginally beneficial. Insoluble fiber may worsen symptoms. Some patients with IBS, especially those with constipation, will improve with increased intake of soluble fiber. Prebiotic fibers have not been adequately tested. Daily use of peppermint oil is effective in relieving IBS symptoms. The usefulness of probiotics in the form of foods such as live-culture yogurt and buttermilk for IBS symptoms is not established. In clinical practice, it is very difficult to establish that a patient's symptoms result from an adverse reaction to food. A double blind placebo-controlled food challenge is the most reliable method, but it is not suitable for routine clinical use. A modified exclusion diet and stepwise reintroduction of foods or trials of eliminating classes of food may be useful.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, USA. wdheizer@earthlink.net

    ,

    Source

    MeSH

    Constipation
    Diet
    Dietary Fiber
    Fermentation
    Food Hypersensitivity
    Fructose Intolerance
    Humans
    Irritable Bowel Syndrome
    Lactose Intolerance
    Plant Oils
    Probiotics
    Randomized Controlled Trials as Topic
    Sorbitol

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19559137

    Citation

    Heizer, William D., et al. "The Role of Diet in Symptoms of Irritable Bowel Syndrome in Adults: a Narrative Review." Journal of the American Dietetic Association, vol. 109, no. 7, 2009, pp. 1204-14.
    Heizer WD, Southern S, McGovern S. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. J Am Diet Assoc. 2009;109(7):1204-14.
    Heizer, W. D., Southern, S., & McGovern, S. (2009). The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. Journal of the American Dietetic Association, 109(7), pp. 1204-14. doi:10.1016/j.jada.2009.04.012.
    Heizer WD, Southern S, McGovern S. The Role of Diet in Symptoms of Irritable Bowel Syndrome in Adults: a Narrative Review. J Am Diet Assoc. 2009;109(7):1204-14. PubMed PMID: 19559137.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. AU - Heizer,William D, AU - Southern,Susannah, AU - McGovern,Susan, PY - 2008/01/29/received PY - 2009/02/04/accepted PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/7/10/medline SP - 1204 EP - 14 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 109 IS - 7 N2 - This review summarizes what is known about the effect of diet on irritable bowel syndrome (IBS) symptoms emphasizing data from randomized, controlled clinical trials. Studies suggest that IBS symptoms in one quarter of patients may be caused or exacerbated by one or more dietary components. Recent studies indicate that a diet restricted in fermentable, poorly absorbed carbohydrates, including fructose, fructans (present in wheat and onions), sorbitol, and other sugar alcohols is beneficial, but confirmatory studies are needed. Despite a long history of enthusiastic use, fiber is marginally beneficial. Insoluble fiber may worsen symptoms. Some patients with IBS, especially those with constipation, will improve with increased intake of soluble fiber. Prebiotic fibers have not been adequately tested. Daily use of peppermint oil is effective in relieving IBS symptoms. The usefulness of probiotics in the form of foods such as live-culture yogurt and buttermilk for IBS symptoms is not established. In clinical practice, it is very difficult to establish that a patient's symptoms result from an adverse reaction to food. A double blind placebo-controlled food challenge is the most reliable method, but it is not suitable for routine clinical use. A modified exclusion diet and stepwise reintroduction of foods or trials of eliminating classes of food may be useful. SN - 1878-3570 UR - https://www.unboundmedicine.com/medline/citation/19559137/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8223(09)00461-1 DB - PRIME DP - Unbound Medicine ER -