The Science, Evidence, and Practice of Dietary Interventions in Irritable Bowel Syndrome

Abstract

Irritable bowel syndrome (IBS) is a highly prevalent disorder that is characterized by symptoms of abdominal pain, bloating, constipation, and/or diarrhea. The diagnosis can be made using Rome III criteria or published guidelines after taking a thoughtful history, excluding warning signs, and performing a careful physical examination. Limited testing (ie, complete blood count and C-reactive protein level) may be useful in appropriate patients. A number of pharmacologic options are available, although many patients fail to respond to pharmacologic therapy. Although several IBS diets frequently are recommended, data supporting their use are limited. This article provides a rationale as to why specific diets might improve IBS symptoms and evaluates published trials.

Keywords: Bloating; Celiac Disease; Diet; FODMAP; Fiber; Fructans; Fructose; Gluten; Irritable Bowel Syndrome; Lactose; Microbiome.