Impact of Diet on Symptoms of the Irritable Bowel Syndrome
Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquera...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/2/575 |
| _version_ | 1797412251011907584 |
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| author | Robin Spiller |
| author_facet | Robin Spiller |
| author_sort | Robin Spiller |
| collection | DOAJ |
| description | Irritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquerade as IBS and may need specialist treatment. While typical food allergy is readily distinguished from IBS, the mechanisms of gut-specific adverse reactions to food are only just being defined. These may include gut-specific mast cell activation as well as non-specific activation by stressors and certain foods. Visceral hypersensitivity, in some cases mediated by mast cell activation, plays a key part in making otherwise innocuous gut stimuli painful. Rapidly fermented poorly absorbed carbohydrates produce gaseous distension as well as short-chain fatty acids and lowering of colonic pH which may cause symptoms in IBS patients. Limiting intake of these in low FODMAP and related diets has proven popular and apparently successful in many patients. Existing diet, colonic microbiota and their metabolic products may be helpful in predicting who will respond. Wheat intolerance may reflect the fact that wheat is often a major source of dietary FODMAPs. It may also be either a forme fruste of coeliac disease or non-specific immune activation. Wheat exclusion can be successful in some of these patients. More research is needed to fully understand the mechanisms of food intolerances and how to best ameliorate them in a personalised medicine approach to diet in IBS. |
| first_indexed | 2024-03-09T04:59:14Z |
| format | Article |
| id | doaj.art-901e7ac81e494bf0b8727dafc65d387c |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T04:59:14Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-901e7ac81e494bf0b8727dafc65d387c2023-12-03T13:01:53ZengMDPI AGNutrients2072-66432021-02-0113257510.3390/nu13020575Impact of Diet on Symptoms of the Irritable Bowel SyndromeRobin Spiller0NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UKIrritable bowel syndrome (IBS), with its key features of abdominal pain and disturbed bowel habit, is thought by both patients and clinicians to be strongly influenced by diet. However, the complexities of diet have made identifying specific food intolerances difficult. Eating disorders can masquerade as IBS and may need specialist treatment. While typical food allergy is readily distinguished from IBS, the mechanisms of gut-specific adverse reactions to food are only just being defined. These may include gut-specific mast cell activation as well as non-specific activation by stressors and certain foods. Visceral hypersensitivity, in some cases mediated by mast cell activation, plays a key part in making otherwise innocuous gut stimuli painful. Rapidly fermented poorly absorbed carbohydrates produce gaseous distension as well as short-chain fatty acids and lowering of colonic pH which may cause symptoms in IBS patients. Limiting intake of these in low FODMAP and related diets has proven popular and apparently successful in many patients. Existing diet, colonic microbiota and their metabolic products may be helpful in predicting who will respond. Wheat intolerance may reflect the fact that wheat is often a major source of dietary FODMAPs. It may also be either a forme fruste of coeliac disease or non-specific immune activation. Wheat exclusion can be successful in some of these patients. More research is needed to fully understand the mechanisms of food intolerances and how to best ameliorate them in a personalised medicine approach to diet in IBS.https://www.mdpi.com/2072-6643/13/2/575irritable bowel syndromedietFODMAPfibreallergy |
| spellingShingle | Robin Spiller Impact of Diet on Symptoms of the Irritable Bowel Syndrome Nutrients irritable bowel syndrome diet FODMAP fibre allergy |
| title | Impact of Diet on Symptoms of the Irritable Bowel Syndrome |
| title_full | Impact of Diet on Symptoms of the Irritable Bowel Syndrome |
| title_fullStr | Impact of Diet on Symptoms of the Irritable Bowel Syndrome |
| title_full_unstemmed | Impact of Diet on Symptoms of the Irritable Bowel Syndrome |
| title_short | Impact of Diet on Symptoms of the Irritable Bowel Syndrome |
| title_sort | impact of diet on symptoms of the irritable bowel syndrome |
| topic | irritable bowel syndrome diet FODMAP fibre allergy |
| url | https://www.mdpi.com/2072-6643/13/2/575 |
| work_keys_str_mv | AT robinspiller impactofdietonsymptomsoftheirritablebowelsyndrome |