A Comparison of the Low-FODMAPs Diet and a Tritordeum-Based Diet on the Gastrointestinal Symptom Profile of Patients Suffering from Irritable Bowel Syndrome-Diarrhea Variant (IBS-D): A Randomized Controlled Trial

Nutrients. 2022 Apr 8;14(8):1544.doi: 10.3390/nu14081544.


Francesco Russo 1Giuseppe Riezzo 1Antonella Orlando 1Michele Linsalata 1Benedetta D'Attoma 1Laura Prospero 1Antonia Ignazzi 1Gianluigi Giannelli 2


Author information

1Functional Gastrointestinal Disorders Research Unit, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, BA, Italy.

2Scientific Direction, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, BA, Italy.


The dietary approach low in oligosaccharides, disaccharides, monosaccharides, and fermentable polyols (FODMAPs-LFD) is a good strategy for treating irritable bowel syndrome (IBS). Beyond the LFD, other dietary approaches with beneficial effects may be hypothesized. Among them, consumption of Tritordeum-based foods (TBD, bread, bakery products, and pasta) in substitution of other cereals seem to achieve promising results. In a randomized controlled trial, we compared the effects of 12 weeks of LFD to TBD in improving the symptom profile of IBS-diarrhea (IBS-D) patients. The two diets equally improved gastrointestinal symptoms and QoL, measured by the IBS Severity Scoring System (IBS-SSS) questionnaire, reducing the total score after four weeks and maintaining this range until the end of treatment (IBS-SSS total score change: -132.1; 95% CI: -74.9 to -189.4 and -130.5; 95% CI: -73.2 to -187.7; p < 0.0001 after LFD and TBD, respectively). The two diets did not modify the micronutrients content when extended for 12 weeks. LFD could be regarded as a first-line dietary approach for IBS-D patients. However, TBD may represent a valid alternative, with high palatability, especially among Italian patients, for whom pasta is considered one of the main assets of dietetic culture, and would be easier to manage in their daily habits.

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