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Irritable bowel syndrome

how can symptoms and quality of life be improved with diet?

Guerreiro, Margaridaa; Sousa Guerreiro, Catarinaa,b,c; Cravo, Maríliaa,d

Current Opinion in Clinical Nutrition & Metabolic Care: September 2019 - Volume 22 - Issue 5 - p 377–382
doi: 10.1097/MCO.0000000000000589
NUTRITION AND THE GASTROINTESTINAL TRACT: Edited by M. Isabel T.D. Correia and André Van Gossum

Purpose of review This article aims to review the current scientific evidence of dietary approaches to control the symptoms of irritable bowel syndrome (IBS).

Recent findings In the last decade, there was an important evolution in the study of the low fermentable oligo, di, mono-saccharides and polyols (FODMAP) diet (LFD). Current scientific evidence suggests a significant efficacy in the overall control of symptoms. LFD seems to be effective in improving quality of life. Recent studies suggest that LFD is effective and nutritionally well tolerated also in the long term, and longer adherence may contribute to greater effectiveness in improving depression. There is insufficient scientific evidence for the recommendation of gluten exclusion in IBS therapy, and some authors still suggest that the efficacy of this approach results from the limited ingestion of fructans. There is a promising efficacy of pre, pro, and symbiotic supplements, but there is no consensus on the most appropriate and effective strains in each case.

Summary Given the poor evidence and the pathophysiological variability of IBS, the interest of each therapeutic option should be always evaluated individually. Nevertheless, LFD is currently the dietary approach with a higher degree of scientific evidence.

aFaculdade de Medicina

bLaboratório de Nutrição

cInstituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa

dHospital Beatriz Ângelo – Serviço de Gastrenterologia, Loures, Portugal

Correspondence to Catarina Sousa Guerreiro, Laboratório de Nutrição, Faculdade de Medicina, Avenida Egas Moniz, 1649-028, Lisbon, Portugal. Tel: +351 217 999 465; e-mail:

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