GOTHENBURG, Sweden — Irritable bowel syndrome is often misunderstood because of its many nuances and complexities. The chronic condition usually causes abdominal cramping, bloating, constipation, and diarrhea. Typically, either diet, medication, or both are used in the treatment. However, new research now shows that dietary treatment is actually more effective than medications when it comes to IBS.
Standard dietary advice for those with IBS includes things like focusing on eating smaller, more frequent meals rather than eating three larger ones. Additionally, greatly limiting common triggers like alcohol and coffee is widely advised. If medications are used, it’s typically to improve certain symptoms like constipation or bloating. Sometimes, even antidepressants are utilized.
To explore things further, a team of researchers conducted a study including adult patients with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg, Sweden. They compared three treatments: two dietary and one based on medication. The first group received conventional IBS dietary advice, like changing certain eating behaviors in combination with eating lower amounts of fermentable carbs — commonly referred to as FODMAPs. High FODMAP foods are dairy and beans that can cause more pain and gas in people with IBS.
The second group was advised to eat a lower-carb, higher protein and fat diet. Then, the third group took medication based on the patient’s most pressing symptoms. Each group had around 100 participants, and the treatment period lasted four weeks. The researchers used an established IBS symptom scoring scale for analysis and found that, among those who received traditional IBS dietary advice and ate low-FODMAP foods, 76 percent had significantly reduced symptoms.
In the second dietary group, 71 percent had significantly reduced symptoms, while only 58 percent did in the medication group. Of note, all groups reported significantly better quality of life and reduced physical and mental symptoms.
At a six-month follow-up, when participants in the dietary groups had partially returned to their typical eating habits, 68 percent still had clinically significant symptom relief in the low FODMAP group, while 60 percent did in the low-carbohydrate diet group.
“With this study, we can show that diet plays a central role in the treatment of IBS, but that there are several alternative treatments that are effective,” says Sanna Nybacka, a researcher, dietitian, and study leader, in a media release.
“We need more knowledge about how to best personalize the treatment of IBS in the future and we will further investigate whether there are certain factors that can predict whether individuals will respond better to different treatment options.”
A Dietitian’s Take
IBS treatment often needs to take many different approaches because of how variable it can present itself. There also isn’t one cause of IBS, which inherently makes effective treatment measures more difficult to pinpoint.
Stress is often considered a big trigger, but a bacterial infection could also be behind someone’s gut trouble. Eating low FODMAP has been a top dietary intervention and definitely helps people find symptom relief as long as they stick to the dietary protocol.
This study showed that a majority of participants who partially returned to their previous eating habits after six months still reported relief. It would be interesting to see how those results hold true after one year or more.
For many with IBS, conventional dietary advice works for the short term, specifically while the guidance is being followed. Typically, once people allow more leniency in their diet, they find themselves back at square one at some point. For these reasons, taking a deeply individualized approach to care for IBS patients is important for providing lasting results. If you think you may be struggling with IBS, be sure to work with an experienced physician and registered dietitian who specializes in gastrointestinal health.
The findings are published in The Lancet Gastroenterology & Hepatology.