World Digestive Health Day WDHD – May 29, 2016 WHAT IS THE ROLE OF FOOD IN IBS, continued Figure 1. Globally, when looking at the evolving literature, a response rate of about 70% might be anticipated when IBS patients are placed on either a low FODMAP diet or gluten-free diet (GFD). Furthermore, there may be long-term benefits with patients continuing their dietetic intervention of their own accord 12- 18 months after the initial dietetic consultation.9 However, the risks associated with restrictive diets (especially nutritional inadequacy, unfavorable effects on the gut microbiota or the encouragement of eating disorders) must be seriously considered, especially when dietary manipulations are professionally unsupervised or purely patient-initiated. In summary there is now an emerging evidence base that nutritional therapies can be used for IBS patients with an expectation of benefit. The selection of diet could be based on clinical judgement, patient preference and local skill-base, or categorization according to the absence or presence of ‘celiac lite’ features (See Figure 1). REFERENCES 1. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(7):712-721.e4. 2. Böhn L, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108(5):634-41. 3. Lind R, Arslan G, Eriksen HR, et al. Subjective health complaints and modern health worries in patients with subjective food hypersensitivity. Dig Dis Sci. 2005;50(7):1245- 51. 4. Berstad A, Undseth R, Lind R, Valeur J. Functional bowel symptoms, fibromyalgia and fatigue: a food-induced triad? Scand J Gastroenterol. 2012;8-9(47):914-9. 5. Aziz I, Hadjivassiliou M, Sanders DS. The spectrum of noncoeliac gluten sensitivity. Nat Rev Gastroenterol Hepatol. 2015 12:516-26. 6. Carroccio A, Mansueto P, Iacono G, et al. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol. 2012;107(12):1898-906; quiz 1907. 7. Biesiekierski JR, Newnham ED, Irving PM, et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011;106(3):508-14; quiz 515. 8. Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology 2013;145(2):320-8.e1-3. 9. Aziz I, Trott N, Briggs R, North JR, Hadjivassiliou M, Sanders DS. Efficacy of a Gluten-free Diet in Irritable Bowel Syndrome-Diarrhea Subjects Blinded to HLA-DQ2/8 Genotype Status. Clin Gastro Hepatol. 2015;15:1715-22. World Digestive Health Day WDHD May 29, 2016 WGO Handbook on DIET AND THE GUT 19
WGO Handbook on Diet and the Gut_2016_Final
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