A NEW randomised, double-blind, sham-controlled trial has found that a personalised elimination diet guided by an IBS-specific IgG antibody assay significantly improves abdominal pain and symptoms in irritable bowel syndrome (IBS) patients. The findings, published in a multicenter clinical trial, provide evidence that an individualised dietary approach may be an effective tool in managing IBS, particularly for those with IBS-C (constipation-predominant) and IBS-M (mixed-type IBS).
The study included 238 IBS patients across eight centers, with 223 analysed in the modified intention-to-treat group. Participants who tested positive for IgG antibodies to at least one of 18 tested foods were randomly assigned to either a targeted elimination diet based on their IgG profile or a sham diet for eight weeks. The primary endpoint was a ≥30% reduction in abdominal pain intensity (API) for at least two of the last four weeks of treatment.
Results showed that 59.6% of patients in the experimental group met the primary endpoint, compared to 42.1% in the sham group (P=0.02). A deeper analysis revealed that patients with IBS-C and IBS-M experienced the greatest benefit, with 67.1% and 66% achieving significant symptom relief, respectively, compared to 35.8% and 29.5% in the sham group.
These findings suggest that an IgG-guided elimination diet could be an effective, personalised approach for IBS management. Given the methodological limitations of previous studies, this trial offers the strongest evidence to date supporting the role of food-specific IgG antibodies in IBS symptom modulation. Researchers emphasise the need for a larger validation study to confirm these promising results and further refine dietary intervention strategies for IBS sufferers.
Aleksandra Zurowska, EMJ
Reference
Singh P et al. A novel, IBS-specific IgG ELISA-based elimination diet in irritable bowel syndrome: A randomized, sham-controlled trial. Gastroenterol. 2025;DOI: 10.1053/j.gastro.2025.01.223.
