The role of diet in irritable bowel syndrome: implications for dietary advice

Rej, Anupam; Aziz, Imran; Törnblom, Hans; Sanders, David S.; Simrén, Magnus

doi:10.1111/joim.12966

Cited by 50 publications

(52 citation statements)

References 78 publications

(127 reference statements)

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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. [207][208][209] The latter emphasises the importance of screening out patients at high risk for such behaviour prior to recommending such diets. [207][208][209] This can be achieved using…”

Section: Fibre and Dietary Therapiesmentioning

confidence: 99%

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British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Vasant

Paine

Black

et al. 2021

Gut

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Irritable bowel syndrome (IBS) remains one of the most common gastrointestinal disorders seen by clinicians in both primary and secondary care. Since publication of the last British Society of Gastroenterology (BSG) guideline in 2007, substantial advances have been made in understanding its complex pathophysiology, resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder. Moreover, there has been a considerable amount of new evidence published concerning the diagnosis, investigation and management of IBS. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients. One of the strengths of this guideline is that the recommendations for treatment are based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of trial-based and network meta-analyses assessing the efficacy of dietary, pharmacological and psychological therapies in treating IBS. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system, summarising both the strength of the recommendations and the overall quality of evidence. Finally, this guideline identifies novel treatments that are in development, as well as highlighting areas of unmet need for future research.

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Section: Fibre and Dietary Therapiesmentioning

confidence: 99%

“…[207][208][209] The latter emphasises the importance of screening out patients at high risk for such behaviour prior to recommending such diets. [207][208][209] This can be achieved using…”

Section: Fibre and Dietary Therapiesmentioning

confidence: 99%

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Vasant

Paine

Black

et al. 2021

Gut

265

334

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“…The authors voice concerns regarding the effectiveness of dietary therapies for functional bowel disorders. However, several studies demonstrate the growing evidence for the use of traditional dietary advice, low FODMAP diet (LFD) and gluten free diet (GFD) for Irritable bowel syndrome (IBS) [3].…”

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confidence: 99%

“…We would disagree that the 5Ad protocol is a 'bottom up' approach, but rather a 'top down' approach, as it involves restriction of high FODMAPs and other dietary components. In contrast, a GFD could be viewed as a 'bottom up' approach, through the reduction of fructans, with a response rate of 30-71% to this diet [3]. Recent research demonstrated patients use gluten free products, classed as 'low fructans foods', whilst on the LFD personalisation stage [4].…”

mentioning

confidence: 99%

A Gluten Reduction Is the Patients’ Choice for a Dietary ‘Bottom Up’ Approach in IBS—A Comment on “A 5Ad Dietary Protocol for Functional Bowel Disorders” Nutrients 2019, 11, 1938

et al. 2020

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“…More than one mechanism contributes to the development of IBS [13]. It's known clearly that dysregulation of the autonomic nervous system, maladjustment of the hypothalamic-pituitary-adrenal axis (HPA), increased pain sensitivity, imbalanced gut microbial population, and altered enteric physiology participate in the pathophysiology of IBS [14]. In recent years, extensive attention has also been paid to the roles of inflammation and immunity Table 2 Comparison of CRF masculine neuron of hypothalamus (expressed by x ± s)…”

Section: Discussionmentioning

confidence: 99%

Cytokines in the colon, central nervous system and serum of irritable bowel syndrome rats

et al. 2021

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Objective The aim of this study was to detect the expression of interleukin (IL)-1β and transforming growth factor (TGF)-β1 in the colonic tissue and serum of irritable bowel syndrome (IBS) rats, as well as the distribution and expression of corticotropin-releasing factor (CRF) in the spinal cord and brain of the visceral hypersensitivity rats, thus to ascertain the mechanism of visceral hypersensitivity signal conduction pathway. Methods The expression of IL-1β and TGF-β1 in the colonic tissue and serum of IBS rats was screened by the liquid chip technology and verified by RT-PCR technology. Then the quantitative analysis of CRF in the spinal cord and brain was achieved by the immunohistochemical method and computerized image system. Result The rat model with visceral hypersensitivity was successfully established. Among the screened indicators of IL-1β and TGF-β1 in colon tissue and serum, only the expression of IL-1β in the model group was up-regulated (P < 0.05). The immunohistochemical method showed that CRF was expressed in the spinal cord, hypothalamus, and the third ventricle. The positive index number of the model groups was higher than that of the control group (P < 0.01). Conclusion From the research, it can be inferred that IL-1β may participate in the pathogenesis mechanism of IBS via regulating the colon function. The increasing expression of CRF linked to stress in the spinal cord, hypothalamus and the third ventricle indicated that it might play an important role in the mechanisms of visceral hypersensitivity signal conduction pathway.

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The role of diet in irritable bowel syndrome: implications for dietary advice

Abstract: Rej A, Aziz I, Tornblom H, Sanders DS, Simr en M (Royal Hallamshire Hospital, Sheffield

Cited by 50 publications

References 78 publications

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

A Gluten Reduction Is the Patients’ Choice for a Dietary ‘Bottom Up’ Approach in IBS—A Comment on “A 5Ad Dietary Protocol for Functional Bowel Disorders” Nutrients 2019, 11, 1938

Cytokines in the colon, central nervous system and serum of irritable bowel syndrome rats

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