Sheffield IBS research recognised as a top 20 high-impact clinical research article of 2022

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Research conducted by the University of Sheffield, investigating the efficacy of dietary treatments for the management of irritable bowel syndrome, has been praised by the American Gastroenterological Association and cited amongst it’s top 20 high-impact clinical research articles of 2022.

Traditional Dietary Advice (TDA) is the first-line dietary therapy recommended in the UK, based on guidance by NICE and the BDA. The low FODMAP diet (LFD) is the second-line dietary therapy for IBS within the UK, involving a reduction in consumption of short-chain, fermentable carbohydrates. A gluten-free diet has also grown in popularity for the management of functional gut symptoms, with approximately 10% of the population reporting that gluten-based products provoke IBS symptoms.

In the absence of any pragmatic head-to-head trials comparing the three diets, this randomised trial sought to investigate the efficacy, acceptability, nutritional and stool microbial changes associated with these diets.

Patients were recruited from 2 secondary care centres in the UK and were randomized to be educated to follow a TDA, LFD or GFD. Participants were seen face-to-face by specialist dietitians and advised to follow their diets for 4 weeks, with outcomes at week 4 compared with baseline. Questionnaires completed pre- and post-intervention, included:

  • IBS symptom severity score (IBS-SSS)
  • Hospital Anxiety & Depression Scale
  • Patient health questionnaire
  • IBS quality of life (QoL) questionnaire
  • Acceptability of dietary restriction questionnaire
  • Food-related QoL questionnaire
  • Comprehensive Nutrition Assessment Questionnaire

Key Findings:

  1. The three diets did not significantly differ in clinical efficacy
  2. The modes of dietary education, either face-to-face or virtual, were equally effective
  3. There was no statistical difference in response rates between IBS-D vs. IBS-M based on a particular dietary therapy
  4. Individuals found TDA cheaper, less time-consuming to shop, and easier to follow when eating out
  5. FODMAP intake was reduced across all groups
  6. Changes in dysbiosis index (DI) did not differ across groups

Discussion & conclusions

TDA, GFD and LFD are effective approaches in non-constipated IBS. The authors of this study recommend TDA as the first-choice dietary option due to its widespread availability and patient friendliness. The LFD or GFD are alternative options based on specific patient preferences and with specialist dietetic counselling.