Abstract
(1) Background: Predictors of dietary treatment response in irritable bowel syndrome (IBS) remain understudied. We aimed to investigate predictors of symptom improvement during the low FODMAP and the traditional IBS diet for four weeks. (2) Methods: Baseline measures included faecal Dysbiosis Index, food diaries with daily energy and FODMAP intake, non-gastrointestinal (GI) somatic symptoms, GI-specific anxiety, and psychological distress. Outcomes were bloating, constipation, diarrhea, and pain symptom scores treated as continuous variables in linear mixed models. (3) Results: We included 33 and 34 patients on the low FODMAP and traditional IBS diet, respectively. Less severe dysbiosis and higher energy intake predicted better pain response to both diets. Less severe dysbiosis also predicted better constipation response to both diets. More severe psychological distress predicted worse bloating response to both diets. For the different outcomes, several differential predictors were identified, indicating that baseline factors could predict better improvement in one treatment arm, but worse improvement in the other treatment arm. (4) Conclusions: Psychological, nutritional, and microbial factors predict symptom improvement when following the low FODMAP and traditional IBS diet. Findings may help individualize dietary treatment in IBS.
Highlights
Licensee MDPI, Basel, Switzerland.Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction (DGBI), formerly known as a functional gastrointestinal (GI) disorder, which affects 4% of the adult global population [1]
We aimed to focus on different baseline factors that are of importance in the pathophysiology of irritable bowel syndrome (IBS)
Clinical Characteristics were included in the analysis
Summary
Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction (DGBI), formerly known as a functional gastrointestinal (GI) disorder, which affects 4% of the adult global population [1]. According to the diagnostic Rome IV criteria, IBS is characterized by weekly abdominal pain associated with altered bowel habits [2]. Pathophysiological factors that are described up until today include altered gut-brain interactions, visceral hypersensitivity [4], abnormal GI motility [5,6], psychosocial factors, altered mucosal immune function and permeability [7,8,9], altered gut microbial environment with potential dysbiosis (imbalance in the microbiota homeostasis) [10,11], and food hypersensitivity [12]
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