Are dietary treatments more effective for IBS?

The study, published in The Lancet Gastroenterology & Hepatology, compared three treatments: two dietary and one based on use of medications.

Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain, gas, bloating, diarrhea, and constipation. Treatment typically involves dietary changes like eating small, frequent meals and avoiding triggers such as coffee and alcohol. Medications may also be prescribed to alleviate symptoms like gas, constipation, diarrhea, and bloating. In some cases, antidepressants are used to manage IBS symptoms.

In the study, participants with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg were divided into three treatment groups. One group received traditional dietary advice focusing on low-FODMAP foods, another received a low-carbohydrate, high-protein and high-fat diet, and the third group was treated with medication tailored to their specific symptoms. Treatment lasted for four weeks, and the participants' responses were assessed using an IBS symptom scoring scale.

The results showed that of those who received traditional IBS dietary advice and low content of FODMAPs, 76% had significantly reduced symptoms. In the group receiving low carbohydrates and high protein and fat, the proportion was 71%, and in the medication group 58%. All groups reported significantly better quality of life, less physical symptoms and less symptoms of anxiety and depression.

“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. 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,” said Sanna Nybacka, lead author of the study.

Reference: Sanna Nybacka, PhD, et al; A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARBIS): a single-centre, single-blind, randomised controlled trial; Journal: The Lancet Gastroenterology & Hepatology; DOI:https://doi.org/10.1016/S2468-1253(24)00045-1