Scientists Found What Works Better

Dietary treatment is more effective than medications for irritable bowel syndrome (IBS). These are the conclusions of a study carried out at the University of Gothenburg. With dietary adjustments, more than seven out of ten patients experienced significantly reduced symptoms.

Irritable bowel syndrome (IBS) is a common diagnosis that causes abdominal pain, gasy abdominal bloating, diarrhea, and constipation, in various combinations and with varying degrees of severity.

Treatment often consists of dietary advice such as eating small, frequent meals and avoiding excessive consumption of dietary triggers such as coffee, alcohol and soda. Patients may also be given medications to improve specific symptoms, such as gas or constipation, diarrhea, bloating, or abdominal pain. Antidepressants are sometimes used to improve IBS symptoms.

The current study, published in

” data-gt-translate-attributes=”({“attribute”:”data-cmtooltip”, “format”:”html”})” tabindex=”0″ role=”link”>The Lancet Gastroenterology & Hepatology, compared three treatments: two dietary and one based on the use of medications. Participants were adult patients with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg.

More symptom relief after a dietary adjustment

The first group received traditional IBS dietary advice, focusing on eating behavior combined with low intake of fermentable carbohydrates, called FODMAPs. These include, for example, products containing lactose, legumes, onions and cereals, which ferment in the colon and can cause pain in IBS.

The second group received a dietary treatment low in carbohydrates and proportionally high in protein and fat. In the third group, the best possible medication was administered based on the patient’s most bothersome IBS symptoms.

Each group included approximately 100 participants and the treatment periods lasted four weeks. When the researchers then looked at how well participants responded to treatments, using an established IBS symptom rating scale, the results were clear.

Sanna Nybacka, Stine Störsrud and Magnus Simrén, Sahlgrenska Academy of the University of Gothenburg. Credit: Photo by Margareta G. Kubista), Malin Arnesson and Johan Wingborg

Among those who received traditional dietary advice regarding IBS and low FODMAP, 76% experienced significantly reduced symptoms. In the group receiving low carbohydrates and high in proteins and fats, the proportion was 71%, and in the drug group 58%.

All groups reported significantly better quality of life, fewer physical symptoms, and fewer symptoms of anxiety and depression.

The importance of personalization

At a six-month follow-up, when participants in the diet groups had partially returned to their previous eating habits, a large proportion still had clinically significant relief of their symptoms; 68% in the traditional and low FODMAP dietary advice group, and 60% in the low-carb diet group.

The study was led by Sanna Nybacka, researcher and dietician, Stine Störsrud, associate professor, and Magnus Simrén, professor and senior consultant, all at the Sahlgrenska Academy at the University of Gothenburg.

“With this study we can show that diet plays a central role in the treatment of IBS, but that there are several effective alternative treatments,” explains Sanna Nybacka.

“We need more knowledge about how best to personalize IBS treatment in the future and we will further study whether there are certain factors that can predict whether individuals will respond better to different treatment options,” concludes -She.

Reference: “A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARBIS): a single-center, single-blind, randomized controlled trial” by Sanna Nybacka, Hans Törnblom, Axel Josefsson, Johann P Hreinsson, Lena Böhn, Åsa Frändemark, Cecilia Weznaver, Stine Störsrud and Magnus Simrén, April 18, 2024, The Lancet Gastroenterology and Hepatology.
DOI: 10.1016/S2468-1253(24)00045-1