Diet Outperforms Medication in Managing IBS Symptoms: Study

By George Citroner

If you are battling irritable bowel syndrome (IBS), then your next prescription might be found in your kitchen.

A study published in April 2024 shows that simple dietary changes outperform medication in managing IBS symptoms. And the relief lasts. Six months later, most patients who stuck to their new eating habits still enjoyed significant benefits.

Diet Versus IBS Medication

Typical dietary advice for IBS sufferers includes eating smaller, more frequent meals instead of three large ones and limiting common triggers like coffee or milk. When medication is used, it usually aims to relieve symptoms such as constipation, bloating, or diarrhea.

The study, published in The Lancet–Gastroenterology & Hepatology, examined 294 people (241 women, since IBS is more common in women, and 53 men) with moderate to severe IBS, comparing three treatments over four weeks: two dietary approaches and medication. The dietary approaches included traditional IBS advice about reducing fermentable carbohydrates (FODMAPs)—sugars like candy and starches like potatoes—and a low-carbohydrate diet.

The medication group received treatments based on their primary symptoms: laxative fiber supplements like Sterculia (karaya gum) for constipation or anti-diarrheal drugs like loperamide (Imodium) for diarrhea.

All groups reported improved quality of life, fewer physical symptoms, and reduced anxiety and depression. However, dietary interventions showed more significant improvement: 76 percent following traditional advice and 71 percent on the low-carb diet experienced reduced symptoms, compared to 58 percent in the medication group.

At a six-month follow-up, many participants in the dietary groups maintained significant symptom relief: 68 percent following traditional advice and 60 percent on the low-carb diet still experienced benefits.

“With this study, we can show that diet plays a central role in the treatment of IBS, but that there are several alternative treatments that are effective,” Sanna Nybacka, a dietitian, associate professor at the University of Gothenburg in Sweden, and lead researcher, said in a press release. “We need more knowledge about how to best personalize the treatment of IBS in the future.”

When Diet Is Not Enough

Dr. David Purow, New York-based Northwell Health’s eastern regional director for gastrointestinal endoscopy and not associated with the study, said his team has long recommended a low-FODMAP diet for IBS patients. “This study confirms findings we have seen with our patients,” he noted.

The human gut poorly digests FODMAP foods, Dr. Christine Frissora, a gastroenterologist at Weill Cornell Medicine who was also not associated with the study, told The Epoch Times. “The undigested fragments are eaten by gut bacteria, which then produce gas,” she added. This leads to gut dysmotility, impairment of gut muscles that move food, and gastrointestinal distress, she noted.

Dr. Frissora, who said the study findings did not surprise her, cited her own 2022 research showing that about 70 percent of IBS patients can’t properly digest carbohydrates. “We tested hundreds of patients with chronic IBS symptoms, and 20 percent had sucrose (table sugar) malabsorption,” she noted.

While dietary changes are critical in IBS treatment, they don’t work for everyone. Many improve on a low-FODMAP diet, but not all, as the study shows, too, Dr. Purow said.

For IBS patients who don’t respond to low-FODMAP or low-carb diets, other drug-free options include the following:

• Probiotics: These beneficial gut bacteria help regulate the microbiome, alleviating IBS symptoms. Probiotics, which are found in yogurt, kefir, kimchi, sauerkraut, and fermented vegetables, are also available as supplements.
• Psyllium: This soluble fiber helps regulate bowel movements and reduce IBS symptoms. It can be taken as a supplement or added to food.
• Peppermint oil: This is an anti-spasmodic that relaxes intestinal muscles, potentially reducing IBS symptoms.
• Cognitive behavioral therapy: This talk therapy helps individuals identify and change negative thought patterns and behaviors that may contribute to IBS symptoms.
• Acupuncture: Research suggests acupuncture may alleviate IBS symptoms by stimulating specific points that help regulate the digestive system.

Consulting a health care provider is crucial to determine the best treatment plan for managing symptoms and improving quality of life.