Plain language summary
Irritable bowel syndrome (IBS) is characterised by inflammation and leaks in the intestine barrier, known as “leaky gut”. Causes of leaky gut may be extensive, and sugar has been reported to correlate with the condition, leading to stomach complaints. The aim of this randomised control trial of 105 IBS patients was to determine the effect of a low starch and sucrose diet on IBS symptoms. The results showed that a modified diet decreased IBS symptom severity in the gastrointestinal tract and improved symptoms of muscle/joint pain, urinary urgency, and tiredness. It was concluded that a low starch and sucrose diet improves IBS symptoms in the whole body. This could be due to alterations in the gut microbiota, a decrease in the accumulation of undigested carbohydrates in the bowel, reduced inflammation, or genetic defects in processing sucrose which have remained undetected may be responsible. This study could be used by healthcare professionals to recommend a low starch and sugar diet to improve symptoms in individuals with IBS.
Abstract
Patients with irritable bowel syndrome (IBS) exhibit low-grade inflammation and increased gut permeability. Dietary sugar has been shown to contribute to low-grade inflammation and increased gut permeability, and to correlate with gastrointestinal (GI) symptoms. The aim of the present study was to examine the effect of a starch- and sucrose-reduced diet (SSRD) on gastrointestinal (GI) and extra-intestinal symptoms in IBS. One hundred and five IBS patients (82 women, 46.06 ± 13.11 years), with irritable bowel syndrome-symptom severity scale (IBS-SSS) > 175, were randomized to SSRD for 4 weeks or continued ordinary eating habits. The visual analog scale for irritable bowel syndrome (VAS-IBS), IBS-SSS, and 4-day food diaries were collected at baseline and after 2 and 4 weeks. After the intervention, one-third of the patients did not fulfill the criteria for IBS/functional gastrointestinal disorder. Half of the participants changed from moderate/severe disease to no/mild disease according to IBS-SSS. Comparisons between the groups showed decreased weight and sweet cravings, and parallel decreases in total IBS-SSS and extra-intestinal IBS-SSS scores, in the intervention group compared to controls (p < 0.001 for all). When calculating separate extra-intestinal symptoms, belching (p = 0.001), muscle/joint pain (p = 0.029), urinary urgency (p = 0.017), and tiredness (p = 0.011) were decreased after introduction of SSRD compared to controls. In conclusion, SSRD improves both GI and extra-intestinal symptoms in IBS.
Methodological quality
Jadad score
:
1
Allocation concealment
:
No
