The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

Abstract

Abstract. Most patients with irritable bowel syndrome (IBS) believe that diet plays a significant role in inducing IBS symptoms and desire to know what foods to avoid. It has been found that the intake of calories, carbohydrates, proteins and fat by IBS patients does not differ from that of the background population. IBS patients were found to avoid certain food items that are rich in fermentable oligo-, di-and monosacharides and polyols (FODMAPs), but they did have a high consumption of many other FODMAP-rich food items. The diet of IBS patients was found to consist of a low calcium, magnesium, phosphorus, vitamin B2 and vitamin A content. There is no consistent evidence that IBS patients suffer from food allergy, nor is there documented evidence that food intolerance plays a role in IBS symptoms. Abnormalities in gut hormones have been reported in IBS patients. As gut hormones control and regulate gastrointestinal motility and sensation, this may explain the abnormal gastrointestinal motility and visceral hypersensitivity reported in these patients. Guidance concerning food management which includes individually based restrictions of FODMAP-rich food items and individual evaluation of the effects of protein-, fat-and carbohydrate-rich/poor diets may reduce IBS symptoms.

Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome

“…The most commonly reported triggers are carbohydrates and fatty foods, milk and dairy products, wheat products, caffeine, hot spices, certain meats, cabbage, onions, peas, beans and fried and smoked foods (16)(17)(18)(19). Despite these reported effects, numerous studies have demonstrated that dietary composition does not markedly differ between patients with IBS and controls (15)(16)(17)(18)(19)(20)(21), although patients with IBS appear to have a low intake of calcium, potassium, magnesium, vitamin A, vitamin B 12 In a previous study by our group, dietary guidance administered individually to patients with IBS reduced the symptoms of the condition and improved their quality of life, in addition to affecting their habitual diet so that their intake of minerals and vitamins became normalized (18). However, two groups of patients with IBS were compared in the study; one group received individual dietary guidance, whilst the second did not receive any dietary guidance.…”

Diet in the pathophysiology and management of irritable bowel syndrome

“…1,2 There are at least 10 types of endocrine cell, and they regulate gastrointestinal motility, secretion, absorption, visceral sensitivity, local immune defense, cell proliferation, and appetite. [2][3][4] Abnormal densities of gastrointestinal endocrine cells have been reported in patients with IBS, which may explain the dysmotility, visceral hypersensitivity, and abnormal intestinal secretion seen in these patients. 5 But other factors such as diet, intestinal microbiota, genetics, and low-grade infl ammation …”

“…7 Nonceliac gluten sensitivity is often perceivable by patients, resulting in self-diagnosis and self-treatment. 4 However, it is not clear whether it is gluten or the fructans and galactans in wheat that are responsible for triggering their symptoms. 7 …”

Current Dietary Approaches in Bowel Diseases: Low Fermentable Oligo-, Di- and Mono-Saccharides and Polyols (FODMAP) Diet: Review

“…24 İBS'de besin allerjisi varlığı ve İBS semptomlarında besin intoleransının da rol oynayacağına dair kesin bir kanıt mevcut değildir. 25 Bunlara ek olarak, son dönemde düşük FODMAP içerikli diyetin İBS semptomlarının iyileşmesinde olumlu etkilerinin olduğunu gösteren çalışmalar mevcuttur. [26][27][28] DÜŞÜK FODMAP İÇERİKLİ DİYET Düşük FODMAP içerikli diyet, fermente oligosakkaritler, disakkaritler, monosakkaritler ve polyollerin diyette azaltılması prensibine dayanmaktadır.…”