Low-FODMAP, gluten-free diet improves IBS symptoms
Patients with irritable bowel syndrome had improved symptom severity and normalized gut microbiota while following a low-FODMAP diet combined with a gluten-free diet, according to data published in BMC Gastroenterology.
“Recently, dietary components including wheat, gluten and fermentable oligo-di-monosaccharides and polyols have been suggested to play an essential role in the induction of IBS symptoms. Accordingly, there is some evidence supporting a clinically relevant positive effect for low-FODMAP and gluten-free diets in patients with IBS,” Kaveh Naseri, Shahid Beheshti University of Medical Sciences, and colleagues wrote. “The significant effect acknowledged to date is alterations in gut microbiota by varying gluten intake. ... However, the roles of alterations of gut microbiota due to the reduction in FODMAP intake in ongoing efficacy have yet to be explored.”
In an uncontrolled, open-label clinical trial, researchers aimed to investigate the effect of a low-FODMAP, gluten-free diet (LF-GFD) on the clinical symptoms, intestinal microbiota diversity and fecal calprotectin levels in 30 patients (50% men; mean age, 37.8 years) with IBS. Patients underwent personalized LF-GFD intervention adjusted to match energy, macronutrient and micro-nutrient daily requirements. Researchers assessed symptom severity using the IBS symptom severity score (IBS-SSS) and collected fecal samples for comparison at baseline and following intervention.
After 6 weeks, IBS-SSS decreased in 73.3% of patients and approximately 52% of patients experienced a 30% to 60% reduction in IBS-SSS. Fecal calprotectin also significantly decreased from baseline (83.4 vs. 37.3). Further, researchers noted microbial differences in post-intervention fecal samples compared with baseline; specifically, increased Bacteroidetes (11.69% vs. 26.65%) and a decreased Firmicutes to Bacteroidetes ratio (2.6:1 vs. 0.8:1).
“Our study suggests that patients with IBS who consumed LF-GFD had a significant improvement in IBS symptoms and normalization of their gut microbiota,” Naseri and colleagues concluded. “Future studies are still required to validate the robustness of our findings and to establish a long-term efficacy and safety of this dietary intervention for personalized nutrition in IBS.”