Irritable Bowel Syndrome: The Importance of Individualization

Did you know that Irritable Bowel Syndrome (IBS) is the most diagnosed gastrointestinal disorder in the world? It is estimated that affect, approximately, 10-15% of the world's population. (1,2) 

But what is the IBS? IBS is a chronic functional gastrointestinal disorder that can cause abdominal pain, bloating, and altered bowel habits in the absence of identifiable structural abnormalities. The exact pathophysiology of IBS remains complex and multifactorial. (2) 

Dietary factors are increasingly recognized as symptom modulators in IBS patients, making nutritional therapy a cornerstone of treatment. These are the IBS most reported triggers (3): 

Nutritional Approaches to IBS 

Nutrition plays a key role in the management of IBS symptoms. However, there is no single dietary approach that suits all patients. Instead, several evidence-based nutritional strategies can be effective, depending on individual symptom profiles, food tolerances, and lifestyle factors. 

FODMAPs are poorly absorbed short-chain carbohydrates including fructose, lactose, polyols, fructans, and galacto-oligosaccharides. The low FODMAP (Fermentable oligo, di and monosaccharides and Polyols) diet is the most extensively studied dietary intervention for IBS. Multiple randomized controlled trials have demonstrated its efficacy in reducing global IBS symptoms and improves quality of life in IBS subjects when compared to a control diet. (2,4) 

However, the diet is complex, restrictive, and not intended for long-term use in its elimination phase. It requires careful reintroduction and personalization to avoid nutritional deficiencies and negative impacts on the gut microbiome.  

Before the adoption of low FODMAP strategies, traditional dietary advice focusing on regular meal patterns, reducing caffeine, alcohol, and fatty food intake, and increasing soluble fibre was commonly recommended. Evidence suggests that this simpler approach can benefit many IBS patients and may be a first-line option. (5) 

Fibre supplementation, particularly with soluble fibre like psyllium, has been shown to improve symptoms in some IBS patients. However, insoluble fibres (e.g., bran) may worsen symptoms in others. Because of that, a tailored approach to fibre intake is essential. (6) 

Some IBS patients report symptom relief on a gluten-free diet, especially those with overlapping non-celiac gluten sensitivity. While the evidence is mixed, a subset of IBS patients, particularly those with diarrhea-predominant IBS, may benefit from a gluten-free diet. Nevertheless, it is unclear whether symptom improvement is due to the removal of gluten or concurrent reduction in fructans (a FODMAP). (7) 

Emerging evidence suggests that anti-inflammatory dietary patterns, such as the Mediterranean diet, may benefit some IBS patients through their positive effects on gut microbiota and systemic inflammation, but others suggest that several mediterranean diet foods are associated with increased IBS symptoms. (8) 

Conclusion and Oh! My Snacks’ position 

Despite the evidence supporting various diets, no single nutritional strategy is universally effective for all IBS patients. Personalized dietary therapy, guided by a registered dietitian, considers the individual's symptom pattern, food preferences, nutritional needs, and lifestyle. It may also consider psychosocial factors, comorbidities, and even microbiome composition in the future. 

IBS is a heterogeneous condition that requires a multifaceted and individualized management plan. While the low FODMAP diet has robust evidence supporting its efficacy, other dietary strategies such as traditional advice, fibre modulation, gluten-free diets, and anti-inflammatory diets also play important roles, but other promising therapies are emerging and should be the subject of further study. (9) 

Nutritional therapy for IBS should not follow a “one-size-fits-all” approach but rather be tailored to the needs and responses of each patient, ideally under professional supervision.  

At Oh!My Snacks we have some alternatives, depending on the diet you are following. Here’s a list of snacks that may be appropriate for you*, with no lactose and no gluten ingredients:  

* Remember that each case of IBS is different and should be monitored by health professionals specialised in the area, such as a dietitian. 

Bibliography