|
About eight out of ten persons who suffer from
irritable bowel syndrome (IBS) believe that the
symptoms are due to diet. A diet that excludes
particularly indigestible carbohydrates can provide
markedly reduced symptoms, as shown by a thesis at
the Sahlgrenska Academy.
In the thesis at hand, 197 persons with IBS symptoms
were asked what they believe is the cause of their
symptoms. In all, 84 percent referred to food
intolerance - they most often described a
hypersensitivity to fatty foods, histamine-releasing
foods (shellfish, eggs), foods with preservatives
(sour milk, lingon berries) and foods rich in
biogenic amines (cheese, wine).
But above all, IBS symptoms were reported in
conjunction with consumption of food containing
indigestible carbohydrates. This food group, which
is popularly called FODMAPs, includes apples, beans
and wheat.
In the study, IBS patients tried a “low -FODMAP
diet” during four weeks - with good results.
“This diet excludes foods that contain large amounts
of indigestible carbohydrates and replace them with
other foods better tolerated by the stomach and
intestines. This may, for instance, involve
replacing apples and cauliflower with oranges and
carrots.”
“About half of the IBS patients improved
significantly with the “low FODMAP diet,” says Lena
Böhn, doctoral student at the Sahlgrenska Academy.
The results were compared with another group that
followed traditional dietary advice in IBS, which
involves eating small and frequent meals, to peel
and divide foods into pieces, chew thoroughly,
reduce fatty and spicy foods, coffee and alcohol.
Also in this group, the IBS symptoms were reduced in
about half of the patients.
“Both of the diets have an equally good effect when
it comes to alleviating IBS symptoms. Future studies
should therefore look at the benefit of combining
them both to optimize nutritional intake and symptom
reduction” says Lena Böhn.
In the studies, experiments were also done where IBS
patients were given a special enzyme, called alpha-galactosidase,
which is known to have the ability to break down
some of the indigestible FODMAP carbohydrates. The
hypothesis was that the enzyme would simplify their
uptake in the small intestine and thereby reduce the
fermentation in the large intestine that may cause
IBS symptoms.
“Unfortunately, it didn’t help, and we found no
evidence that supplements of the enzyme alpha-galactosidase
are beneficial for IBS,” says Lena Böhn.
The thesis shows that despite a high degree of
self-reported food intolerance in IBS patients, the
majority seem to have adequate nutrient intake.
The researchers’ conclusion is that dietary advice
is effective in the treatment of IBS. However, it is
important to assess the nutrient intake at an
individual level and specify what foods the patient
consider to cause symptoms in order to provide
individual dietary advice.
The thesis Food-related gastrointestinal symptoms,
nutrient intake and dietary interventions in
patients with irritable bowel syndrome was defended
at a public dissertation on January 30.
For more information
Food-related gastrointestinal symptoms, nutrient
intake and dietary interventions in patients with
irritable bowel syndrome
https://gupea.ub.gu.se/handle/2077/37527.
MDN |