2022-02-09 08:30:49
A double blind, placebo controlled randomized clinical trial investigated the impact of low FODMAP diets with vs without gluten on IBS symptoms. The aim of the study was to determine which wheat constituent, fructans or gluten, is the culprit for triggering IBS symptoms.
All participants consumed a low FODMAP diet for six weeks, with the intervention group (n = 26) also taking 5g/day of gluten powder and the control group (n = 23) 5g/day of rice flour.
The primary outcome was a significant reduction in symptoms, measured using the IBS Severity Scoring System (IBS-SSS). Symptoms included abdominal pain intensity and frequency, abdominal distention, bowel habits satisfaction, interference with community function, and stool consistency and frequency. Quality of life was measured as a secondary outcome using the IBS QOL questionnaire.
Results showed significant improvements in total IBS-SSS scores and clinical symptoms in both groups, with the placebo experiencing a higher improvement in stool frequency and consistency compared to the intervention. Symptoms worsened in 5 participants on gluten supplementation, which could confirm the concept of non-celiac gluten sensitivity being present in some IBS patients. It may be interpreted that wheat and barley exaggerate IBS symptoms mainly through their fructan content, with gluten only being the responsible culprit in a small percentage of IBS patients.
Références
Mohseni, F., Agah, S., Ebrahimi-Daryani, N., Taher, M., Nattagh-Eshtivani, E., Karimi, S., Rastgoo, S., Bourbour, F., & Hekmatdoost, A. (2022). The effect of low FODMAP diet with and without gluten on irritable bowel syndrome: A double blind, placebo controlled randomized clinical trial. Clinical nutrition ESPEN, 47, 45–50. https://doi.org/10.1016/j.clnesp.2021.12.019