Gastroenterol Clin North Am. 2021 Sep;50(3):565-579.doi: 10.1016/j.gtc.2021.03.005. Epub 2021 Jun 25.

Emily Haller ¹, Kate Scarlata ²

Author information

• ¹Division of Gastroenterology and Hepatology, Michigan Medicine, 3912 Taubman Center, 1500 East Medical Center Drive SPC, 5362, Ann Arbor, MI 48109-5362, USA. Electronic address: emilyhal@umich.edu.
• ²For a Digestive Peace of Mind, LLC Medway, MA 02053, USA. Electronic address: https://twitter.com/KateScarlata_RD.

Abstract

Patients with irritable bowel syndrome (IBS) frequently perceive eating food as a trigger to their gastrointestinal (GI) distress. Several factors involved in driving GI symptoms include malabsorption and fermentation of food substrates, gut microbiota alterations, nocebo and placebo response, and mast cell activation. Nutritional interventions require individualization based on the heterogeneity of symptoms as well as the risk for maladaptive eating patterns that present in those with IBS. Despite the variety of interventions marketed to individuals with IBS, the low Fermentable, Oligo-, Di-Mono-saccharide, and Polyol diet has the most evidence for efficacy in symptom management.