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BMJ Clin Evid. 2015 Jul 30;2015. pii: 0410.

Irritable bowel syndrome: dietary interventions.

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Leeds Gastroenterology Institute, St James's University Hospital, and Leeds Institute of Biomedical and Clinical Sciences, Leeds, UK.



The prevalence of irritable bowel syndrome (IBS) varies depending on the criteria used to diagnose it, but it ranges from about 5% to 20%. IBS is associated with abnormal gastrointestinal motor function and enhanced visceral perception, as well as psychosocial and genetic factors. People with IBS often have other bodily and psychiatric symptoms, and have an increased likelihood of having unnecessary surgery compared with people without IBS.


We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of dietary modification (gluten-free diet, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols [FODMAPs]) in people with irritable bowel syndrome? We searched Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).


At this update, searching of electronic databases retrieved 33 studies. After deduplication and removal of conference abstracts, 19 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 14 studies and the further review of five full publications. Of the five full articles evaluated, three RCTs were included. Based upon their own search, the contributor(s) added two additional RCTs that did not meet Clinical Evidence inclusion criteria; these have been added to the Comment section. We performed a GRADE evaluation of the quality for two PICO combinations.


In this systematic overview, we categorised the efficacy for two interventions based on information relating to the effectiveness and safety of dietary modification (gluten-free diet or a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols [FODMAPs]).

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