Managing Symptom Profile of IBS-D Patients With Tritordeum-Based Foods: Results From a Pilot Study

Abstract

In the past few years, increasing attention has been given to the pathologic role of specific foods in IBS, like wheat and other cereals. Recent literature describes IBS patients who may experience gastrointestinal (GI) and extra-GI symptoms precipitated by the ingestion of cereals. Tritordeum is a cereal of Spanish origin derived from the hybridization of durum wheat and wild barley. It is different from classic wheat for its gluten protein composition, with fewer carbohydrates and fructans and a higher content of proteins, dietary fibers, and antioxidants. This pilot study aimed to investigate the effects of a 12-week diet with Tritordeum-based foods in substitution of other cereals on the profile of GI symptoms (evaluated by appropriate questionnaire) and the health of the GI barrier (assessed by sugar absorption test and different markers of integrity and functions) in 16 diarrhea-predominant IBS (IBS-D) patients. The diet with Tritordeum-based foods (bread, bakery products, and pasta) significantly reduced IBS-D patients' symptoms. This amelioration appears to occur through an overall improvement of the GI barrier, as demonstrated by the reduced intestinal permeability and the decreased levels of markers of intestinal mucosal integrity, mucosal inflammation, and fermentative dysbiosis.

A Tritordeum-Based Diet for Female Patients with Diarrhea-Predominant Irritable Bowel Syndrome: Effects on Abdominal Bloating and Psychological Symptoms

“…Tritordeum has lower levels of gliadin, carbohydrates, and fructans and higher fiber, protein, and antioxidant content than classical wheat. Although it is unsuitable for celiac patients, it may be helpful for subjects with non-celiac type wheat sensitivity (NCWS) or those IBS-D patients who benefit from removing wheat from the diet because of the onset of symptoms such as abdominal pain and bloating following its intake [ 15 ]. In addition, compared with the low-FODMAPs diet (LFD), a diet based on Tritordeum products (TBD) seems closer to Italians’ eating habits and more accessible to follow than other dietetic regimens [ 16 ].…”

Consumption of Tritordeum Bread Reduces Immunogenic Gluten Intake without Altering the Gut Microbiota

“…Moreover, preliminary results suggest that tritordeum could be an option for a set of NCWS patients [28]. Furthermore, a recent pilot study also concluded that tritordeum foods could significantly reduce certain IBS symptoms by an overall improvement of the gastrointestinal barrier [29].…”

“…Although not suitable for celiac patients, tritordeum can be considered an alternative for NCWS patients who do not need strict gluten exclusion from their diet [28], and for people who wish to reduce their daily gluten intake. Moreover, the diet with Tritordeum-based foods (bread, bakery products, and pasta) significantly reduced IBS patients' symptoms in a pilot study [29].…”

Evaluation of the Effects of the Tritordeum-Based Diet Compared to the Low-FODMAPs Diet on the Fecal Metabolome of IBS-D Patients: A Preliminary Investigation

“…Nutritionists examined the completed food diaries to calculate the daily energy intake of carbohydrates, lipids, proteins, and dietary fibers. A special software (Progetto Dieta v. 2.0, accessed 18 January 2022) was used [ 6 , 7 , 13 ].…”

“…As recently described by our group [ 13 ], patients with IBS-D who received a tritordeum-based diet (TBD) for 12 weeks experienced significant reductions in gastrointestinal (GI) symptoms. This effect can be attributed to the overall improvement of the GI barrier, evidenced by decreased intestinal permeability (IP) and favorable changes in intestinal barrier integrity, along with reduced mucosal inflammation and fermentative dysbiosis.…”