A NOVEL immunoglobulin G (IgG)-guided elimination diet has demonstrated potential in reducing abdominal pain in patients with irritable bowel syndrome (IBS), according to a new randomised controlled trial.
Researchers conducted a double-blind, sham-controlled trial across eight centres, enrolling patients with IBS who tested positive for at least one food sensitivity on an 18-food IgG assay. Participants reported an average abdominal pain intensity score between 3.0–7.5 on an 11-point scale during a 2-week run-in period. Subjects were then randomised to either an antibody-guided elimination diet or a sham diet for 8 weeks. The primary endpoint was a reduction of at least 30% in abdominal pain intensity for 2 or more of the last 4 weeks of treatment.
Of the 238 randomised participants, 223 were included in the modified intention-to-treat analysis. A significantly greater proportion of patients in the experimental diet group met the primary outcome compared to the sham diet group (59.6% vs 42.1%, P=0.02). Subgroup analysis revealed a particularly strong effect in patients with constipation-predominant IBS and IBS with mixed bowel habits, where response rates in the experimental group were markedly higher than in the sham group (67.1% vs 35.8% and 66% vs 29.5%, respectively).
These findings suggest that an IgG-guided elimination diet may offer an effective personalised dietary intervention for IBS, particularly in specific subgroups. Further large-scale studies are needed to confirm these results and refine dietary recommendations for clinical practice.
Reference
Singh P et al. A novel, IBS-specific IgG ELISA-based elimination diet in irritable bowel syndrome: a randomized, sham-controlled trial. Gastroenterology. 2025; DOI: 10.1053/j.gastro.2025.01.223.
