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Insufficient evidence to support gluten-free diet for IBS
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New research revealed a lack of evidence to support initiating a gluten-free diet to alleviate symptoms of irritable bowel syndrome.
However, Joanna Dionne, MD, MSc, FRCP, PhD, of the division of gastroenterology at McMaster University in Hamilton, Ontario, and colleagues found that a diet low in fermentable oligo-, di- and monosaccharides and polyols (FODMAPs) did help reduce symptoms in patients with IBS.
Because of the dietary triggers of IBS, Dionne and colleagues wrote that many patients turn to dietary approaches to treat their symptoms.
“It is important to give patients evidence-based advice on which diets may be effective in reducing their symptoms,” they wrote. “Initial approaches that based dietary recommendations for food sensitivities had disappointing efficacy in randomized trials, but recent dietary approaches have shown more promise.”
Dionne and colleagues conducted a systematic review and meta-analysis of the literature and searched for randomized controlled trials that evaluated an exclusion diet vs. an alternative or usual diet. Inclusion required that the trials had to assess improvement in either global IBS symptoms or abdominal pain.
Nine studies that fit their criteria: two centered on a gluten-free diet (n = 111) and seven assessed a low-FODMAP diet (n = 397).
Dionne and colleagues found that a gluten-free diet was associated with reduced global symptoms compared with a control diet (RR = 0.42; 95% CI, 0.11-1.55). However, the link was not statistically significant.
Additionally, they found that a low-FODMAP diet was associated with reduced symptoms compared with control diets (RR = 0.69; 95% CI, 0.54-0.88).
Although they found evidence to support the use of a low-FODMAP diet for IBS, Dionne and colleagues wrote that the quality of data was not strong because the trials used different comparator groups and included a relatively low number of patients.
“The findings of this review demonstrate that, at present, there is insufficient evidence to recommend a [gluten-free diet] to reduce global IBS symptoms,” the researchers wrote. “There is very low-quality evidence that a low-FODMAP diet is effective in reducing global symptoms in IBS patients. More data are needed, but of the available dietary interventions, a low-FODMAP diet currently has the greatest evidence for efficacy in IBS.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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