Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8837
Revised: April 3, 2014
Accepted: June 2, 2014
Published online: July 21, 2014
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in Western countries. Despite the high prevalence of this disorders, the therapeutic management of these patients is often unsatisfactory. A number of factors have been suggested to be involved in the pathogenesis of IBS, including impaired motility and sensitivity, increased permeability, changes in the gut microbiome and alterations in the brain-gut axis. Also food seems to play a critical role: the most of IBS patients report the onset or the exacerbation of their symptoms after the meals. Recently, an increasing attention has been paid to the role of food in IBS. In this review we summarize the most recent evidences about the role of diet on IBS symptoms. A diet restricted in fermentable, poorly absorbed carbohydrates and sugar alcohols has beneficial effects on IBS symptoms. More studies are needed to improve our knowledge about the relationship between food and IBS. However, in the foreseeable future, dietary strategies will represent one of the key tools in the therapeutic management of patients with IBS.
Core tip: The most of irritable bowel syndrome patients reported food as a trigger of gastrointestinal symptoms and self-referred intolerance to certain food items. However, it is difficult identify which items are involved in symptoms triggering because food is a complex milieu of several chemicals, almost all potentially able to induce symptoms via several ways. It has been proposed three pathogenic mechanisms by which food items might induce symptoms: via immune activation (food hypersensitivity), via direct action of bioactive molecules (food chemicals) and via luminal distension.