A NEW study conducted at Sahlgrenska University Hospital, Gothenburg, Sweden, has revealed that dietary treatments may be more effective than pharmacological options for managing irritable bowel syndrome (IBS) symptoms.
The trial, involving 294 participants, compared two dietary interventions with optimised medical treatment targeting predominant IBS symptoms. Participants were assigned to one of three groups: a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) plus traditional IBS dietary advice recommended by the UK National Institute for Health and Care Excellence (LFTD diet), a fibre-optimised diet low in total carbohydrates and high in protein and fat (low-carbohydrate diet), or optimised medical treatment based on predominant IBS symptom. The primary measure of success was a reduction of at least 50 points on the IBS Severity Scoring System (IBS-SSS) after 4 weeks.
The results showed that dietary interventions led to significantly higher response rates than medical treatment. In the LFTD group, 76% of participants (73 out of 96) experienced substantial symptom relief, followed by 71% (69 out of 97) in the low-carbohydrate group. In comparison, only 58% (59 out of 101) of participants in the medical treatment group achieved the same improvement. The difference between groups was statistically significant (P=0.023).
Completion rates for the 4-week intervention were high across all groups: 95% for both dietary groups and 90% for the medical treatment group. Adverse events were minimal and similar across groups, with only two participants in each group citing adverse effects as a reason for discontinuation. Five participants in the medical treatment group discontinued due to side effects, but no severe adverse events or treatment-related deaths were reported.
The study highlights the potential of dietary interventions as a first-line treatment for IBS. Researchers noted that the effects of the LFTD and low-carbohydrate diets were both meaningful and safe, offering hope for patients seeking alternative approaches to symptom management. Future research will focus on personalising treatment strategies to further improve outcomes.
Ada Enesco, EMJ
Reference
Nybacka S et al. A low FODMAP diet plus traditional dietary advice versus a low-carbohydrate diet versus pharmacological treatment in irritable bowel syndrome (CARIBS): a single-centre, single-blind, randomised controlled trial. Lancet Gastroenterol Hepatol. 2024;9(6):507-520.
