A groundbreaking study conducted at the University of Gothenburg has revealed that dietary adjustments are more effective than medications for managing symptoms of irritable bowel syndrome (IBS). Published in The Lancet Gastroenterology & Hepatology, the study found that over 70% of patients experienced significant symptom relief with dietary interventions, compared to 58% with medication.
Understanding IBS and Current Treatment Approaches
IBS is a common gastrointestinal disorder that affects millions of individuals worldwide, causing symptoms such as:
- Abdominal pain
- Gas and bloating
- Diarrhea
- Constipation
Treatment typically involves a combination of dietary recommendations and symptom-specific medications. Patients are often advised to:
- Eat small, frequent meals
- Avoid trigger foods like coffee, alcohol, and fizzy drinks
- Use medications to target specific symptoms (e.g., bloating or diarrhea)
In severe cases, antidepressants may also be prescribed to alleviate symptoms.
Study Design and Methods
The study, conducted at Sahlgrenska University Hospital in Gothenburg, compared three treatment strategies for adults with moderate to severe IBS symptoms:
- Traditional IBS dietary advice with low-FODMAP foods: A diet focusing on reducing fermentable carbohydrates (FODMAPs), such as lactose, legumes, onions, and grains, which can cause symptoms in IBS patients.
- Low-carbohydrate, high-protein, high-fat diet: This dietary approach shifts the macronutrient balance to emphasise protein and fat.
- Pharmacological treatment: Patients received the best available medications tailored to their most bothersome IBS symptoms.
Each group consisted of approximately 100 participants who underwent their respective treatments for four weeks. The efficacy of the treatments was assessed using an established IBS symptom scoring system.
Key Findings
The study’s results highlight the significant benefits of dietary treatments over medications:
- Traditional IBS dietary advice with low-FODMAP foods: 76% of participants experienced significant symptom reduction.
- Low-carbohydrate, high-protein, high-fat diet: 71% reported reduced symptoms.
- Pharmacological treatment: 58% of participants saw symptom improvement.
All groups also reported enhanced quality of life, reduced physical symptoms, and decreased anxiety and depression.
Long-Term Benefits
At a six-month follow-up, many participants who had returned to their previous eating habits still experienced clinically significant symptom relief:
- 68% in the low-FODMAP group
- 60% in the low-carbohydrate diet group
This sustained improvement underscores the potential for dietary strategies to provide lasting relief for IBS symptoms.
Implications for IBS Treatment
Their findings emphasize the central role of diet in IBS management and highlight the importance of personalized treatment approaches.
“Diet plays a central role in the treatment of IBS, but there are several alternative treatments that are effective,” said Sanna Nybacka.
Future research aims to identify factors that can predict individual responses to various treatments, paving the way for more tailored and effective IBS management strategies.
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Reference
Nybacka, S., et al. (2024). 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. The Lancet Gastroenterology & Hepatology. DOI:10.1016/S2468-1253(24)00045-1