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Use of Diet and Probiotic Therapy in the Irritable Bowel Syndrome: Analysis of the Literature

Floch, Martin H MD

Journal of Clinical Gastroenterology: May-June 2005 - Volume 39 - Issue 5 - p S243-S246
doi: 10.1097/01.mcg.0000156104.67505.5b
Spectrum of Gastrointestinal Disorders
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Goal: The goal of this report is to review the use of dietary intake and probiotics in patients with irritable bowel syndrome (IBS) in published reports.

Background: Dietary factors can be important in inducing symptoms that occur in patients with the IBS. Dietary intolerances, dietary allergies, specific food metabolites, and regular diet contents all may act as triggers and aggravate the symptoms of IBS; but when any of these mechanisms can be proven to cause the symptoms, then their elimination results in the resolution of that patient's IBS.

Methods: Our previous review was updated. In addition, a careful Medline search was made for the years from 1975 to 2004 to evaluate human research reports on diet and probiotics in the IBS. Forty-six manuscripts were reviewed on diet and six were available on probiotic use in IBS. The most common dietary factor evaluated in the literature was bran, and the most common probiotic used was Lactobacillus plantarum.

Conclusions: Although investigations have shown that bran may be helpful in some patients, a complete review of the literature does not reveal conclusive evidence that diet therapy is effective in IBS. From the limited reports on probiotics, there appears to be a trend to decreasing symptoms. It is clear that much more prospective research is needed to study both dietary factors and probiotics in these areas.

From the Section of Gastroenterology, Yale University School of Medicine, Norwalk Hospital, Norwalk, CT.

Received for publication November 3, 2004; accepted December 20, 2004.

Reprints: Martin H. Floch, MD, Section of Gastroenterology, Yale University School of Medicine, Norwalk Hospital, 30 Stevens Street, Suite E, Norwalk, CT 06856 (e-mail: martinfloch@snet.net).

© 2005 Lippincott Williams & Wilkins, Inc.