Food supplements and diet as treatment options in irritable bowel syndrome

Abstract

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder affecting 5.7% of the general population. Most patients relate their symptoms of IBS to foods they consume with diet being the most frequently reported factor impacting their life. However, although some foods may trigger symptoms, others may provide symptom relief. Indeed, several foods and diets have been investigated for their effectiveness in relieving IBS symptoms. In this issue of Neurogastroenterology and Motility, a double‐blind randomized placebo‐controlled trial in 160 patients with IBS demonstrated Aloe vera not to be effective in improving IBS symptoms. The aim of this review is to discuss the evidence on the effect of food supplements and diets in the management of IBS. Specifically, this review examines the evidence for aloe vera, peppermint oil, probiotics, fiber and prebiotics, healthy eating, the low FODMAP diet, and the gluten‐free diet.

Of bowels, brain and behavior: A role for the gut microbiota in psychiatric comorbidities in irritable bowel syndrome

“…125 The use of food supplements and diet as treatment options has recently been evaluated in this journal. 126 These varied approaches reflect a willingness to target multiple levels of the gut-brain axis to deliver gastrointestinal symptom relief.…”

“…The integration of psychological behavioral approaches into gastroenterology practice is now more routinely considered, 124 building on the success of gut‐focused hypnotherapy as an option in treatment‐refractory IBS 125 . The use of food supplements and diet as treatment options has recently been evaluated in this journal 126 . These varied approaches reflect a willingness to target multiple levels of the gut‐brain axis to deliver gastrointestinal symptom relief.…”

Nopal fiber (Opuntia ficus‐indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial

“…The proposed mechanisms underpinning the therapeutic potential of dietary fiber in irritable bowel syndrome (IBS) include modulation of the microbiota and their metabolites, including short‐chain fatty acids (SCFA) 2–4 in addition to regulating regional gut transit time and impacting stool form (e.g., stool bulking, stool softening) 5,6 . Although numerous trials and systematic reviews of fiber in IBS have been performed, the evidence for effectiveness is often conflicting, 7–9 likely reflecting differences in dose and duration of the intervention, the limited understanding of the different types of dietary fibers investigated, and variations in their functions in different IBS subtypes 10 .…”

Letter: faecal microbiota transplantation for irritable bowel syndrome—which improvements are required?

“…Since the genetic composition contributes to the formation of the intestinal microbiota, the donor chosen was not related to any of the patients in that trial. Moreover, since dietary modifications and nutritional supplements also influence the intestinal microbiota, 5 the donor's diet was compared with those of 35 healthy subjects, and was found to be within the normal range for those subjects. However, the donor regularly took dietary supplements rich in proteins, vitamins, fibre and minerals that made his diet richer in those substances 4 .…”