Effect of Three Diets (Low-FODMAP, Gluten-free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life

Nutrients. 2019 Jul 11;11(7):1566. doi: 10.3390/nu11071566.


Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients' quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.

Keywords: FODMAPs; IBS; balanced diet; diet; diet treatment; gluten-free diet; irritable bowel syndrome; quality of life.

Publication types

  • Clinical Trial

MeSH terms

  • Abdominal Pain
  • Adult
  • Diet, Gluten-Free*
  • Diet, Mediterranean*
  • Feces
  • Female
  • Humans
  • Irritable Bowel Syndrome / diet therapy*
  • Male
  • Monosaccharides / administration & dosage*
  • Quality of Life
  • Young Adult


  • Monosaccharides