One trial found that two diets appeared to be more effective in treating irritable bowel syndrome (IBS) than taking medication.Recently, relevant research was published in Lancet-Gastroenterology and Liver Disease.
A diet designed to be low in "FODMAPs" – a group of sugars and similar carbohydrates found in dairy products, wheat, and certain fruits and vegetables.The second is a less common approach for IBS — an adaptive low-carb diet rich in fiber but low in all other types of carbohydrates, namely sugar and starch.
In a randomized trial, both diets improved symptoms better after four weeks than standard medication.
IBS can cause a bewildering array of symptoms, including diarrhea, constipation, bloating, and abdominal pain, which can vary in strength over time.The root cause of this situation is unclear.
The usual advice is to avoid common triggers, such as caffeine, alcohol, or spicy foods.People can also take symptomatic treatment, such as taking laxatives to treat constipation or medications to treat diarrhea.
If these measures don't work, people can also try to reduce foods high in FODMAP, which is thought to cause bloating and diarrhea because they are often undigested before reaching the colon.This promotes water retention in the colon and produces gas when bacteria consume molecules, which causes bloating.
Sanna Nybacka and colleagues at the University of Gothenburg in Sweden wanted to see how the usual low-FODMAP diet could compete with different approaches to low-carbohydrate diets while still consuming large amounts of fiber.In practice, this means eating foods that are high in fat and protein, such as meat and dairy, while fiber sources include nuts, seeds, legumes and vegetables, such as cabbage.
The team asked about 300 IBS patients to choose one of three approaches: taking medication based on symptoms, or taking one of two diets.When it comes to dietary approaches, researchers provide these people with detailed meal plans and recipes.
A month later, 76 percent of patients in the low-FODMAP group reported significant symptom relief, compared with 71 percent in the low-carbohydrate diet group and 58 percent in the drug treatment group.
Nybacka says the most surprising thing is that a low-carbohydrate, high-fiber diet containing FODMAP is not ruled out as effective as a low-FODMAP diet."We cannot answer why this is so.It seems that changing carbohydrate levels and reducing FODMAP intake may be beneficial.”
But Hazel Everitt of the University of Southampton in the UK said it would be better if the trial lasted longer."The problem with many of the proposed IBS diets is that they are difficult to maintain for a long time," she said.”
Participants were followed up for up to six months, but in the final five months, participants who were initially given medication were also given dietary advice.
Nybacka said a potential problem with low-carb, high-fiber diets is that blood cholesterol levels in this group have risen slightly.Therefore, people should consult their doctor before adopting this diet.