Are Rice and Spicy Diet Good for Functional Gastrointestinal Disorders?

Abstract

Rice- and chili-containing foods are common in Asia. Studies suggest that rice is completely absorbed in the small bowel, produces little intestinal gas and has a low allergenicity. Several clinical studies have demonstrated that rice-based meals are well tolerated and may improve gastrointestinal symptoms in functional gastrointestinal disorders (FGID). Chili is a spicy ingredient commonly use throughout Asia. The active component of chili is capsaicin. Capsaicin can mediate a painful, burning sensation in the human gut via the transient receptor potential vanilloid-1 (TRPV1). Recently, the TRPV1 expressing sensory fibers have been reported to increase in the gastrointestinal tract of patients with FGID and visceral hypersensitivity. Acute exposure to capsaicin or chili can aggravate abdominal pain and burning in dyspepsia and IBS patients. Whereas, chronic ingestion of natural capsaicin agonist or chili has been shown to decrease dyspeptic and gastroesophageal reflux disease (GERD) symptoms. The high prevalence of spicy food in Asia may modify gastrointestinal burning symptoms in patients with FGID. Studies in Asia demonstrated a low prevalence of heartburn symptoms in GERD patients in several Asian countries. In conclusion rice is well tolerated and should be advocated as the carbohydrate source of choice for patients with FGID. Although, acute chili ingestion can aggravate abdominal pain and burning symptoms in FGID, chronic ingestion of chili was found to improve functional dyspepsia and GERD symptoms in small randomized, controlled studies.

Impact of Eating Attitude and Impairment of Physical Quality of Life Between Tertiary Clinic and Primary Clinic Functional Dyspepsia Outpatients in Japan

“…Although to date there have been but few reports on the clinical symptoms and diet of FGIDs patients, reports that specific foods and types of food are related to symptoms have begun to appear. [43][44][45] In our study, there was significant difference in physical quality of life and eating attitudes in two different FD populations such as tertiary clinic and primary clinic FD outpatients. Further studies will be needed to investigate the difference in both impairment of physical quality of life and eating attitudes between tertiary clinic and primary clinic FD outpatients.…”

Chromogranin A cell density in the large intestine of Asian and European patients with irritable bowel syndrome

“…It has been postulated that a reduced intestinal cell density is caused by abnormal stem cell clonogeny and differentiation progeny toward endocrine cells, and that the change in the proportions of endocrine cell types is caused by switching on and off of the production of certain hormones [59]. The absence of abnormality in the colonic endocrine cell density in Thai IBS patients suggests that the pathophysiology of IBS in these patients is different from that in the Norwegians Several hypotheses have been put forward to explain the differences between Asians and Western patients with IBS, including a hygiene hypothesis model and differences in the intestinal microbiota and diet [60][61][62]. In the hygiene model, Gwee speculated that the high exposure to infectious agents at childhood in Asia results in the intestine being colonized with favorable bacteria and the development of broad immune tolerance [61].…”

The current treatment landscape of irritable bowel syndrome in adults in Hong Kong: consensus statements

“…6 Food allergy testing is not recommended in patients with IBS 25 ; nonetheless important dietary considerations include FODMAPs, fibre, chilli, lactose, and gluten. 23 Coeliac disease is rare in the Chinese population; data suggest that wheat is not completely absorbed in the small bowel and may produce gastrointestinal symptoms. 23 Although the primary carbohydrate in the Chinese diet is rice, there is a strong influence of western cuisine in Hong Kong and wheat is found in many traditional Hong Kong-style foods.…”

“…23 Coeliac disease and non-coeliac gluten sensitivity are rare in Chinese populations and therefore trial of a gluten-free diet is not warranted in Chinese patients. 24 Statement 10: Health care practitioners should exercise caution in recommending excessively restrictive diets that could lead to malnutrition, quality of life impairment, or psychological distress (as a result of the difficulty of adherence).…”