Abstract
Given the link between the minimal inflammation underlying irritable bowel syndrome (IBS) and dietary treatments, considerable attention has focused on diets low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). In this context, inflammatory patterns and lipidomic investigations may shed light on the pathophysiological mechanisms whereby a low-FODMAP diet (LFD) improves the IBS diarrhoea (IBS-D) variant. Thus, we investigated whether a long-term LFD induced changes in symptom profiles, anthropometric characteristics, inflammatory markers (C-reactive protein, cyclooxygenase-2, and prostaglandin E2) and erythrocyte-membrane fatty acid (FA) composition in IBS-D patients. Twenty IBS-D patients underwent a 90 day personalised LFD programme, and were regularly evaluated at scheduled visits. At the diet’s end, both IBS symptoms and anthropometric parameters were significantly improved. A significant decrease in prostaglandin E2 also accompanied these reductions. As for FAs, the putative inflammatory indicators, arachidonic acid (AA) levels and the AA/eicosapentaenoic acid ratio were significantly decreased. In conclusion, IBS-D patients following a controlled long-term LFD experienced improved symptom profiles and decreased inflammatory markers linked to FAs. Lipidomic data may be insightful for unravelling the molecular mechanisms associated with IBS-D pathophysiology.
Highlights
Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disease that significantly affects patient quality of life
Eighty-two (72 F and 10 M) subjects suffering from irritable bowel syndrome (IBS)-D were recruited into this study
We investigated whether a long-term low-FODMAP diet (LFD) under constant nutritional control could positively affect patient symptom profiles, anthropometric characteristics, inflammatory patterns and erythrocyte-membrane fatty acid (FA) composition in IBS diarrhoea (IBS-D) patients
Summary
Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disease that significantly affects patient quality of life. IBS is characterised by abdominal pain or discomfort, classically linked to changes in bowel habits. A high percentage (10%–15%) of the general population, mainly in Western, industrialised areas, suffer from IBS. IBS affects more females than males [1]. IBS development is a key factor for GI specialist referral. Pain severity and associated psychological distress (in some cases) are key determinants for patients seeking increased medical healthcare. An IBS diagnosis is still primarily based on specific GI symptom questionnaires, stool characteristics and the exclusion of organic GI diseases [2]
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