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Diet in irritable bowel syndrome.

Abstract

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coeliac gluten sensitivity (NCGS). The component in wheat that triggers symptoms in NCGS appears to be the carbohydrates. Patients with NCGS appear to be IBS patients who are self-diagnosed and self-treated with a gluten-free diet. IBS symptoms are triggered by the consumption of the poorly absorbed fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fibre. On reaching the distal small intestine and colon, FODMAPS and insoluble fibre increase the osmotic pressure in the large-intestine lumen and provide a substrate for bacterial fermentation, with consequent gas production, abdominal distension and abdominal pain or discomfort. Poor FODMAPS and insoluble fibres diet reduces the symptom and improve the quality of life in IBS patients. Moreover, it changes favourably the intestinal microbiota and restores the abnormalities in the gastrointestinal endocrine cells. Five gastrointestinal endocrine cell types that produce hormones regulating appetite and food intake are abnormal in IBS patients. Based on these hormonal abnormalities, one would expect that IBS patients to have increased food intake and body weight gain. However, the link between obesity and IBS is not fully studied. Individual dietary guidance for intake of poor FODMAPs and insoluble fibres diet in combination with probiotics intake and regular exercise is to be recommended for IBS patients.

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    ,

    Department of Medicine, Section for Gastroenterology, Stord Hospital, Stord, Norway. magdy.el-salhy@helse-fonna.no. Department of Clinical Medicine, Section for Gastroenterology, University of Bergen, Box 4000, 54 09, Stord, Norway. magdy.el-salhy@helse-fonna.no. Department of Medicine, National Centre for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway. magdy.el-salhy@helse-fonna.no.

    Department of Research, Helse-Fonna, Haugesund Hospital, Haugesund, Norway. Doris.Irene.Gundersen@helse-fonna.no.

    Source

    Nutrition journal 14: 2015 Apr 14 pg 36

    MeSH

    Diet
    Diet, Gluten-Free
    Dietary Carbohydrates
    Dietary Fiber
    Enteroendocrine Cells
    Exercise
    Feeding Behavior
    Fermentation
    Gastrointestinal Microbiome
    Humans
    Irritable Bowel Syndrome
    Probiotics
    Quality of Life

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    25880820

    Citation

    El-Salhy, Magdy, and Doris Gundersen. "Diet in Irritable Bowel Syndrome." Nutrition Journal, vol. 14, 2015, p. 36.
    El-Salhy M, Gundersen D. Diet in irritable bowel syndrome. Nutr J. 2015;14:36.
    El-Salhy, M., & Gundersen, D. (2015). Diet in irritable bowel syndrome. Nutrition Journal, 14, p. 36. doi:10.1186/s12937-015-0022-3.
    El-Salhy M, Gundersen D. Diet in Irritable Bowel Syndrome. Nutr J. 2015 Apr 14;14:36. PubMed PMID: 25880820.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diet in irritable bowel syndrome. AU - El-Salhy,Magdy, AU - Gundersen,Doris, Y1 - 2015/04/14/ PY - 2015/01/24/received PY - 2015/03/31/accepted PY - 2015/4/17/entrez PY - 2015/4/17/pubmed PY - 2016/1/20/medline SP - 36 EP - 36 JF - Nutrition journal JO - Nutr J VL - 14 N2 - Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coeliac gluten sensitivity (NCGS). The component in wheat that triggers symptoms in NCGS appears to be the carbohydrates. Patients with NCGS appear to be IBS patients who are self-diagnosed and self-treated with a gluten-free diet. IBS symptoms are triggered by the consumption of the poorly absorbed fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fibre. On reaching the distal small intestine and colon, FODMAPS and insoluble fibre increase the osmotic pressure in the large-intestine lumen and provide a substrate for bacterial fermentation, with consequent gas production, abdominal distension and abdominal pain or discomfort. Poor FODMAPS and insoluble fibres diet reduces the symptom and improve the quality of life in IBS patients. Moreover, it changes favourably the intestinal microbiota and restores the abnormalities in the gastrointestinal endocrine cells. Five gastrointestinal endocrine cell types that produce hormones regulating appetite and food intake are abnormal in IBS patients. Based on these hormonal abnormalities, one would expect that IBS patients to have increased food intake and body weight gain. However, the link between obesity and IBS is not fully studied. Individual dietary guidance for intake of poor FODMAPs and insoluble fibres diet in combination with probiotics intake and regular exercise is to be recommended for IBS patients. SN - 1475-2891 UR - https://www.unboundmedicine.com/medline/citation/25880820/full_citation L2 - https://nutritionj.biomedcentral.com/articles/10.1186/s12937-015-0022-3 DB - PRIME DP - Unbound Medicine ER -