What is the role of gluten free diet in IBS? Although many IBS patients empirically report an improvement in symptoms on a gluten-free diet, rigorous evidence from controlled trials is lacking. After a 4-week trial in 45 IBS-D patients of a gluten-containing or a gluten-free diet, patients on the gluten-containing diet had more bowel movements …
Can diet modification improve IBS symptoms? Most patients report that certain foods exacerbate their symptoms and some have adopted an inappropriately restrictive diet. Dietary history can help to determine if a significant correlation exists between a particular food and IBS symptoms. If a correlation exists, the offending food should be eliminated from the diet to …
What is the treatment approach to IBS? The first avenue of treatment in all IBS patients is lifestyle modification, including moderate or vigorous exercise (if tolerated), a well-balanced diet, stress reduction, and plenty of sleep. If unsuccessful, pharmacologic treatments based on the predominant symptom and severity should be considered. In patients with severe symptoms or …
How is small intestinal bacterial overgrowth tested? SIBO can be evaluated by breath testing and, more recently, small bowel culture. Although there are no definitive recommendations on the use of breath testing to diagnose SIBO, this test has become popular after evidence suggesting that IBS patients were more likely to have a positive SIBO breath …
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What is the role of small intestinal bacterial overgrowth (SIBO) in IBS? SIBO is a condition in which excessive levels of bacteria, predominantly the colonic-type species, are present in the small intestine. SIBO appears to be more common in IBS, although the reported incidence of SIBO varies according to the detection method employed. A recent …
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Should suspected IBS have celiac disease testing? It is recommended by the American College of Gastroenterology Task Force that serologic testing for celiac disease (i.e., tissue transglutaminase antibody) be performed on all patients with suspected IBS-D and IBS-M. Although previous studies have found an increased incidence of celiac disease among patients with IBS, a recent …
What is the role of lactose intolerance? Lactose intolerance can cause symptoms similar to those associated with IBS. The prevalence of lactose intolerance is slightly higher in adults with IBS; however, lactose intolerance is not the cause of IBS in most patients. Nevertheless, because of the similarity in symptoms, patients with symptoms suggestive of lactose …