A new diet against irritable bowel syndrome

alexraths/epictura

Published the 24.10.2017 to 16h23

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Keywords :

Bowel Syndrome irritabledouleurballonnementdiarrhéerégime

Its symptoms will rot the lives of those who suffer from irritable bowel syndrome or ” functional colopathy “, but there is something new. In these individuals, a diet low in fermentable sugars (low-FODMAP) offers notable relief of intestinal problems and reduces the symptom scores validated. This reduction is demonstrated in a controlled study and compared to the diet-placebo.

The co-administration of probiotics increases the diversity of the intestinal flora (the number of species of Bifidobacterium in the stool) without, however, affect the digestive symptoms. These are the findings of a controlled study published in the journal Gastroenterology.

A double question

It is a double-controlled trial, using a technique validated (factorial design 2 × 2). It was carried out among 104 people (aged 18 to 65 years) with irritable bowel syndrome in the United Kingdom.

The patients were drawn between a group receiving advice to follow a diet-placebo or a group with a diet low in fermentable carbohydrates (a diet low in FODMAP = fructose, lactose, mannitol, sorbitol…) for 4 weeks. The draw was also the supplementation of the daily ration of probiotic bacteria and this has allowed us to obtain 4 groups : (27 receiving on a diet-placebo and the placebo of probiotic, 26 receiving a diet-placebo / probiotic, 24 receiving a diet low in FODMAP / placebo probiotic, and 27 receiving a diet low in FODMAP / a probiotic).

Dietary advice was given to all patients, and data on the food consumed, and the compliance of the plans adopted in relation to the schemes recommended have been collected, which ensures the quality of the results.

Interest of diet on digestive problems

In the analysis carried out on the people who have followed their plan, a significantly higher proportion of those under diet low in FODMAP had an appropriate relief of their digestive problems (61%), compared to the diet-placebo (39%) (P = 0.042). These data are confirmed by the analysis of the evolution of the scores of international (IBS-Severity Scoring System).

Limited interest of probiotics

If there is no difference in the intensity or frequency of gastrointestinal symptoms between those who received probiotics and those who received a placebo, the extent of the diversity of the intestinal flora, and in particular, species of Bifidobacterium, which is lower in fecal samples of patients on diet low in FODMAP, is higher among patients who received probiotics. The diet low in FODMAP had no impact on the diversity of the microbiota in fecal samples.

Validation of an old hypothesis

It is one of the first studies placebo-controlled trial to demonstrate a benefit of a diet poor in fermentable carbohydrates on symptoms of irritable bowel syndrome, but it is not possible in this study to make the difference between which amounts to the restriction of all of the fermentable sugars (fructose, mannitol, lactose, sorbitol, etc.) and the restriction that is isolated from the lactose. The intake of probiotics is associated with an increase in the diversity of Bifidobacterium species in the feces but this increase in the diversity of the intestinal flora do not seem to have a special interaction with the symptomatology.

Limit the fermentable sugars is therefore likely to improve many of the symptoms (pain, bloating, flatulence, incontinence) for at least a portion of the people suffering from irritable bowel syndrome.