Dietary Approach May Be More Effective At Treating IBS Than Medication

IBS is rather unpredictable due to its many nuances and complexities, and its impact can range from mild inconvenience to severe debilitation, the symptoms can vary and are even sometimes contradictory with diarrhea alternating with constipation. Long-term symptoms can affect many aspects of one’s emotional, social, and professional life, with moderate to severe symptoms possibly disrupting physical, emotional, economic, educational, professional, and social well-being as well as limiting individual potential. 

Around 20-40% of gastroenterologist visits are due to IBS symptoms, however, not all those with IBS symptoms seek medical care, despite this there are between 2.4 and 3.5 million annual visits annually in America alone. While there are treatments available for IBS to help manage the symptoms, their effectiveness varies from person to person, and not all treatments work for all people. 

IBS is a chronic condition that typically causes abdominal cramping, bloating, pain, constipation, and diarrhea. Traditionally, diet, medication, or a combination of both are used to treat IBS. More recently, research has been demonstrating that dietary treatment may be more effective than medications when it comes to treating the symptoms of irritable bowel syndrome. 

Those with IBS are often instructed to focus on eating smaller portions and eating the smaller portions more frequently rather than eating three larger meals. Additionally, those with IBS are instructed to limit/avoid things such as stress, alcohol, fizzy drinks, and coffee which are known to be common triggers. Most people with digestive issues will have certain foods that trigger symptoms, and it can take a trial and error-process to identify what their triggers are. 

Research has revealed that our digestive enzymes can’t break down certain types of carbohydrates known as FODMAPs which include starches, sugars, and fibers in food, thus a low FODMAP diet may also help those suffering from food intolerances, which is a common cause of digestive symptoms such as bloating, gas, and abdominal pain. To explore this further, this study published in The Lancet Gastroenterology & Hepatology compared two dietary treatments and one based on medication among adult patients with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg, Sweden.

Each group consisted of around 100 participants and the treatment period was 4 weeks: the first group received conventional IBS dietary advice which included following a low FODMAP diet, the second group was also a dietary group who were advised to consume a lower carb, higher protein, and fat diet, while the third group took medication based on the participants' most recent symptoms. 

According to the researchers,76% of those in the low FODMAP group experienced significantly reduced symptoms, 71% of those in the second group experienced significantly reduced symptoms, and 58% of those in the medication group experienced reduced symptoms. However, all three groups reported significantly improved quality of life as well as reduced physical and mental symptoms. 

After a six-month follow-up when the participants in the dietary intervention groups had partially returned to their regular eating habits, 68% of those in the low FODMAP group and 60% of those in the second dietary intervention group still had clinically significant symptom relief.

“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, the study leader, researcher, dietician, Stine Störsrud, Associate Professor, and Magnus Simrén, Professor and Senior Consultant, all at Sahlgrenska Academy, University of Gothenburg. “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.”