Association between irritable bowel syndrome and micronutrients: A systematic review

Abstract

Background and Aim Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction with a multifactorial etiology. Food trigger avoidance is common among individuals with IBS and exclusion diets are gaining popularity. However, recent guidelines on IBS management cautioned regarding the use of unsupervised dietary therapy with concerns of development of poor eating habits and even nutritional deficiencies. We aimed to review the available literature on the effect of habitual and exclusion diets on micronutrient status as well as the role of micronutrient supplementation in alleviating IBS symptoms. Methods Four electronic databases (PubMed, Embase, Cochrane, Web of Science) were searched for articles that reported micronutrient data in patients with IBS. Serum micronutrient levels and dietary intake of micronutrients in patients with IBS were collected. The extracted data were tabulated and organized by micronutrient type to observe for trends. Results Twenty‐six articles were included in this systematic review (12 interventional and 14 observational studies). Studies showed that generally IBS subjects had lower levels of vitamin B2, vitamin D, calcium, and iron at baseline compared with non‐IBS subjects. Studies also found that exclusion diets were associated with lower intake of micronutrients especially vitamin B1, B2, calcium, iron, and zinc. There was a lack of interventional studies on micronutrients. Conclusion Irritable bowel syndrome patients are at risk of developing multiple micronutrient deficiencies that may have both localized gastrointestinal as well as systemic effects. Dietary management of IBS patients should include a proper dietitian review to ensure nutritional adequacy where possible.

The Role of Calcium, 25-Hydroxyvitamin D and Parathyroid Hormone in Irritable Bowel Syndrome: A Bidirectional Two-Sample Mendelian Randomization Study

“…A systematic review including 12 interventional and 14 observational studies showed that IBS patients generally had lower levels of Vit-D, vitamin B2, calcium and iron compared with control subjects. Meanwhile, studies also found that exclusion diets were associated with deficiencies of the aforementioned micronutrients [6]. As the major circulating form of Vit-D, 25-Hydroxyvitamin D is used as indicator of Vit-D status.…”

“…Recent studies demonstrate that diet and micronutrients play a vital role in the pathophysiology of IBS, and provide some promising dietary therapies including dietary exclusion and dietary supplementation [6]. For example, the low FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet has been a recommended therapy for IBS patients by the American College of Gastroenterology.…”

“…For example, the low FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet has been a recommended therapy for IBS patients by the American College of Gastroenterology. Notably, several epidemiological studies have reported the deficiency of vitamin D (Vit-D) and calcium in IBS patients [6], which indicates that Vit-D and calcium would serve as promising targets for potential dietary therapies.…”

The Role of Calcium, 25-Hydroxyvitamin D, and Parathyroid Hormone in Irritable Bowel Syndrome: A Bidirectional Two-Sample Mendelian Randomization Study

“…Recent studies demonstrate that the diet and micronutrients play a vital role in the pathophysiology of IBS, and over 80% of IBS patients report food triggers for their complaints, such as dairy products, gluten, alcohol, and fried foods [ 6 , 7 ]. Noteworthily, dietary fibers are related to the onset of IBS symptoms, as they can exert effects on nutrients bioavailability, gut motility, stool pattern, and the gut microbiota [ 8 ].…”

“…Moreover, a low-FODMAP diet is a recommended therapy for IBS patients by the American College of Gastroenterology. Notably, several epidemiological studies have reported the deficiency of vitamin D (Vit-D) and calcium in IBS patients [ 7 ], which indicates that Vit-D and calcium would serve as promising targets for potential dietary therapies.…”