A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome

Austin, Gregory L.; Dalton, Christine B.; Hu, Yan; Morris, Carolyn; Hankins, Jane S.; Weinland, Stephan R.; Westman, Eric; Yancy, William S.; Drossman, Douglas A.

doi:10.1016/j.cgh.2009.02.023

Cited by 104 publications

(74 citation statements)

References 17 publications

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“…Adult studies have shown clinical improvement of FD and reflux after weight Childhood obesity and functional disorders S Bonilla et al loss, 28,29 but there is conflicting evidence for other FGIDs. 30 In summary, we found that obesity is associated with poor long-term outcome in children with FGIDs. Obesity is associated with persistence of GI symptoms and disability at long-term follow-up in children with abdominal pain-related FGIDs.…”

Section: Discussionmentioning

confidence: 64%

Obesity predicts persistence of pain in children with functional gastrointestinal disorders

Bonilla

Saps

2010

Int J Obes

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Objective: The possible effect of obesity in the outcome of treated children with abdominal pain-related functional gastrointestinal disorders (FGIDs) has not yet been studied. We hypothesized that obesity is associated with a poor long-term prognosis in children with FGIDs. Study design: Prospective cohort study in an outpatient clinic-based sample of patients diagnosed with abdominal pain-related FGIDs. Principal outcome measured was persistence of pain at long-term follow-up (12-15 months). Frequency of pain, intensity of pain, school absenteeism and disruption of daily activities were compared between obese and non-obese subjects. Results: The group mean age was 13.27 ± 3.84 years, distribution of diagnosis was 32% (functional abdominal pain), 42.5% (irritable bowel syndrome) and 25.5% (functional dyspepsia). Overall, 20.2% of patients were obese. A total of 116 patients (61.7%) reported abdominal pain and 72 (38.3%) were asymptomatic at long-term follow-up. Obese patients were more likely to have abdominal pain (Po0.0001), higher intensity of pain (P ¼ 0.0002), higher frequency of pain (P ¼ 0.0032), school absenteeism (Po0.0001) and disruption of daily activities (Po0.0001) at follow-up than non-obese patients. Conclusion: Obesity is associated with poor outcome and disability at long-term follow-up in children with abdominal pain-related FGIDs. Our novel findings could have important implications in the prognosis and management of FGIDs.

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Section: Discussionmentioning

confidence: 64%

Obesity predicts persistence of pain in children with functional gastrointestinal disorders

Bonilla

Saps

2010

Int J Obes

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“…Most patients with IBS believe diet plays a significant role in their symptoms and 63% desire to know what foods to avoid (28)(29)(30)(31). More than 60% of IBS patients report worsening of symptoms following food ingestion; 28% within 15 min after eating and 93% within 3 h (32).…”

Section: Diet In Ibs Patientsmentioning

confidence: 99%

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

El‐Salhy

Østgaard

Gundersen³

et al. 2012

Int J Mol Med

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Abstract. Most patients with irritable bowel syndrome (IBS) believe that diet plays a significant role in inducing IBS symptoms and desire to know what foods to avoid. It has been found that the intake of calories, carbohydrates, proteins and fat by IBS patients does not differ from that of the background population. IBS patients were found to avoid certain food items that are rich in fermentable oligo-, di-and monosacharides and polyols (FODMAPs), but they did have a high consumption of many other FODMAP-rich food items. The diet of IBS patients was found to consist of a low calcium, magnesium, phosphorus, vitamin B2 and vitamin A content. There is no consistent evidence that IBS patients suffer from food allergy, nor is there documented evidence that food intolerance plays a role in IBS symptoms. Abnormalities in gut hormones have been reported in IBS patients. As gut hormones control and regulate gastrointestinal motility and sensation, this may explain the abnormal gastrointestinal motility and visceral hypersensitivity reported in these patients. Guidance concerning food management which includes individually based restrictions of FODMAP-rich food items and individual evaluation of the effects of protein-, fat-and carbohydrate-rich/poor diets may reduce IBS symptoms.

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“…On average, IBS patients miss 13.4 days of work and school per year (17,23). IBS patients have a high percentage of losing a job, quitting work or turning down a promotion, and work fewer hours as a result of their condition (26,27). More than 60% of IBS patients report worsening of symptoms following food ingestion; 28% within 15 min of eating and 93% within 3 h (28).…”

Section: Introductionmentioning

confidence: 99%

Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome

Østgaard

Hausken

Gundersen³

et al. 2012

Mol Med Report

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Abstract. The present study investigated the diet and quality of life of irritable bowel syndrome (IBS) patients in comparison to the background population. Furthermore, it studied the effects of guidance on diet management on changes in food intake, quality of life and symptoms. A total of 35 healthy controls, 36 IBS patients and 43 IBS patients who had received guidance on diet management 2 years earlier were included. The controls and patients were asked to complete an FFQ questionnaire, an SF-NDI questionnaire, an IBS-QoL questionnaire and a Birmingham IBS symptom score questionnaire. There were no statistical differences in the intake of calories, carbohydrates, proteins and fat between the controls and IBS patients, with or without guidance on diet management. IBS patients made a conscious choice to avoid certain food items, some of which belong to fermentable oligosaccharides, disaccharides, monosacharides and polyols (FODMAPs). They had a higher consumption, however, of other food items that are rich in FODMAPs. They also avoided other food sources which are crucial for their health. Two years after receiving guidance on diet management, IBS patients had a different diet profile. They avoided all FODMAP-rich food, consumed more food with probiotic supplements and did not avoid food sources that were crucial to their health. In addition, they had improved quality of life and reduced symptoms. Although at first sight the diet of IBS patients did not differ from that of the background population, detailed examination showed avoidance of certain food items. Guidance on the management of diet improved their choice of a healthier diet, improved quality of life and reduced IBS symptoms. IntroductionIrritable bowel syndrome (IBS) is a chronic gastrointestinal disorder in absence of any structural, physiological or biochemical abnormalities in the gastrointestinal tract (1). The condition is classified as a functional disorder for which the diagnosis is based on the presentation of symptoms. These symptoms are abdominal discomfort or pain, bloating and abdominal distension, and changes in bowel habit between diarrhoea and constipation (1). The degree of symptoms varies in different patients from tolerable to severe, where the experience of pain may vary from a nagging, colicky, sharp or dull feeling of pain. Also, the time pattern and discomfort varies immensely from patient to patient (2-14). Some complain of daily symptoms, while others report intermittent pain at intervals of weeks/months. The supportive symptoms mentioned above may also be used to subclassify IBS patients into three subtypes: diarrhoea-predominant (IBS-D), constipationpredominant (IBS-C) and alternating constipation/diarrhea (IBS-M) (2-4).The estimated prevalence of IBS varies from 12 to 30%; this large variation is explained by the use of different definitions in different studies (15). A cross-sectional population-based survey conducted in Oppland and Hedmark County in Norway using recent diagnostic criteria estimated the prevalence to affe...

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A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome

Abstract: Background & Aims-Patients with diarrhea-predominant IBS (IBS-D) anecdotally report symptom improvement after initiating a very low-carbohydrate diet (VLCD). This is the first study to prospectively evaluate a VLCD in IBS-D.

Cited by 104 publications

References 17 publications

Obesity predicts persistence of pain in children with functional gastrointestinal disorders

Obesity predicts persistence of pain in children with functional gastrointestinal disorders

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome

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