Irritable bowel syndrome (IBS) can be debilitating and may cause cramping, abdominal pain, bloating, gas, diarrhea, and constipation. IBS can affect one’s work, sleep, and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects. A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (low-FODMAP) diet is not a new treatment. Most functional medicine practitioners often incorporate a low-FODMAP diet for patients with IBS. However, many of the dietary recommendations have not been backed by clinical trials. 

According to a new study published last week in Nutrients, researchers investigated the short- and long-term efficacy, nutritional adequacy, and long-term acceptance of a low-FODMAP in patients with IBS. Patient compliance and the ability to identify food triggers were also evaluated.

This study included 41 patients with IBS who were given a low-FODMAP diet and after 2 months were reintroduced foods, and then retreated with an adapted low-FODMAP diet with a 6-month to 24-month follow-up. At each follow-up visit, questionnaires and Biolectrical Impedance Vector Analysis (BIVA) were performed. As a result, the low-FODMAP diet was effective in controlling gastrointestinal (GI) symptoms, both in the short-term and the long-term, as well as improving quality of life, anxiety, and depression. In addition, the low-FODMAP diet improved the quality of life without effecting nutritional adequacy. It was also noted that the perception of trigger foods was significantly different between the baseline and after 2 months. As a result, the research team demonstrated that even if there were some problems of acceptability and adherence reported, a low-FODMAP is nutritionally adequate and efficacious in improving IBS symptoms in the long-term.

Diet is the most effective means to return balance to and within the GI system. Some patients may need a combination of botanicals, enzymes, and probiotics to optimize the GI environment. Certain diagnostic tests may also be beneficial, including stool testing and food antibody testing.

The GI tract is considered to be the body’s “second brain,” and it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. The GI tract is responsible for all aspects of the digestive process, from the esophagus to the stomach and to the small and large intestines, and it may be responsible for IBS symptoms.

There are other nutrients that can support patients with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote healthy bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains, such as Saccharomyces cerevisiae CNCM I-3856, that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS. 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Bellini M, Tonarell S, Barracca F, et al. A low-FODMAP diet for irritable bowel syndrome: some answers to the doubts from a long-term follow-up. Nutrients. 2020;12(8):2360. doi.org/10.3390/nu12082360.