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Irritable bowel syndrome and diet: where are we in 2018?

Dimidi, Eirini; Rossi, Megan; Whelan, Kevin

Current Opinion in Clinical Nutrition and Metabolic Care: November 2017 - Volume 20 - Issue 6 - p 456–463
doi: 10.1097/MCO.0000000000000416
FUNCTIONAL FOODS AND DIETARY SUPPLEMENTS: Edited by Nathalie M. Delzenne and Gerard E. Mullin
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Purpose of review The aim is to review the most recent advances in the evidence supporting the use of various dietary interventions for the management of irritable bowel syndrome (IBS).

Recent findings There is insufficient evidence of the effect of fibres other than psyllium in IBS, whereas the recent studies on prebiotics suggest a limited effect in IBS. Recent probiotic trials continue to provide varying results, with some probiotic strains exhibiting beneficial effects, whereas others show no effect. Recent trials have also confirmed the clinical effectiveness of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (i.e. low FODMAP diet) in IBS. Although gluten sensitivity has also been recently investigated, its presence cannot be confirmed yet because of the presence of other potential contributing compounds in wheat. Studies also suggest a potential beneficial effect of peppermint oil, which warrants further research.

Summary It is clear that a low FODMAP diet has a beneficial effect in a majority of patients with IBS. Probiotics also have great potential in the management of IBS; however, it is still unclear which strains and doses are the most beneficial. Further research is needed on the effect of different fibres, or combinations of fibres, in IBS.

King's College London, Department of Nutritional Sciences, London, United Kingdom

Correspondence to Professor Kevin Whelan, King's College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK. Tel: +44 20 7848 3858; e-mail: kevin.whelan@kcl.ac.uk

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