Background and Aims: Patients with diarrhea-predominant IBS (IBS-D) anecdotally report symptom improvement after initiating a very low-carbohydrate diet (VLCD). This is the first study to prospectively evaluate a VLCD in IBS-D.
Methods: Participants with moderate to severe IBS-D were provided a 2-week standard diet, then 4 weeks of a VLCD (20 grams of carbohydrates/day). A responder was defined as having adequate relief (AR) of gastrointestinal symptoms for 2 or more weeks during the VLCD. Changes in abdominal pain, stool habits, and quality of life (QOL) were also measured.
Results: Of the 17 participants enrolled, 13 completed the study and all met the responder definition, with 10 (77%) reporting adequate relief for all 4 VLCD weeks.
• Stool frequency decreased (2.6 +/- 0.8/day to 1.4 +/- 0.6/day; p<0.001).
• Stool consistency improved from diarrheal to normal form (Bristol Stool Score: 5.3 +/- 0.7 to 3.8 +/- 1.2; p<0.001).
• Pain scores and QOL measures significantly improved. Outcomes were independent of weight loss.
Conclusion: A VLCD provides adequate relief, and improves abdominal pain, stool habits, and quality of life in IBS-D.
Source: Clinical Gastroenterology and Hepatology, Mar 9, 2009. PMID: 19281859, by Austin GL, Dalton CB, Hu Y, Morris CB, Hankins J, Weinland SR, Westman EC, Yancy WS Jr, Drossman DA. Division of Gastroenterology and Hepatology, University of Colorado Denver, Aurora, Colorado, USA.