Published online Jun 21, 2015. doi: 10.3748/wjg.v21.i23.7089
Peer-review started: February 11, 2015
First decision: March 26, 2015
Revised: April 4, 2015
Accepted: May 7, 2015
Article in press: May 7, 2015
Published online: June 21, 2015
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, having a prevalence of 12%-30% in the general population. Most patients with IBS attribute their symptoms to adverse food reactions. We review the role of diet in the pathogenesis of IBS and the importance of dietary factors in the management of these patients. The MEDLINE electronic database (1966 to Jan 2015) was searched using the following keywords: “food”, “diet”, “food allergy”, “food hypersensitivity”, “food intolerance”, “IBS”, “epidemiology”, “pathogenesis”, “pathophysiology”, “diagnosis”, “treatment”. We found 153 eligible papers; 80 were excluded because: not written in English, exclusive biochemical and experimental research, case reports, reviews, and research otherwise not relevant to our specific interest. We selected 73 papers: 43 original papers, 26 reviews and 4 letters to the editor. These papers focused on IBS pathogenesis, the association between IBS and atopy, and between IBS and food allergy, the relationship between IBS and non-celiac wheat sensitivity, the role of diet in IBS. Pending further scientific evidence, a cautious approach is advisable but the concept of food allergy should be included as a possible cause of IBS, and a dietary approach may have a place in the routine clinical management of IBS.
Core tip: Starting from the late evidences about the non-celiac wheat sensitivity, we reviewed the role of diet in the pathogenesis of irritable bowel syndrome and the importance of dietary factors in the management of these patients. We found 183 papers about the matter, selecting 73 for review. We concluded that food allergy could be a possible cause of irritable bowel syndrome, and a dietary approach should be implemented in clinical practice.