A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome
published online 12 March 2009.
Background & Aims
Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) anecdotally report symptom improvement after initiating a very low-carbohydrate diet (VLCD). This study prospectively evaluated 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 g carbohydrates/d). A responder was defined as having adequate relief of gastrointestinal symptoms for 2 or more weeks during the VLCD. Changes in abdominal pain, stool habits, and quality of life also were 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/d to 1.4 ± 0.6/d; P < .001). Stool consistency improved from diarrheal to normal form (Bristol Stool Score, 5.3 ± 0.7 to 3.8 ± 1.2; P < .001). Pain scores and quality-of-life measures significantly improved. Outcomes were independent of weight loss.
Conclusions
A VLCD provides adequate relief, and improves abdominal pain, stool habits, and quality of life in IBS-D.
⁎Division of Gastroenterology and Hepatology, University of Colorado Denver, Aurora, Colorado
‡University of North Carolina Center for Functional GI and Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill
§Division of General Internal Medicine, Duke University, Durham, North Carolina
∥Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, North Carolina
Reprint requests Address requests for reprints to: Gregory L. Austin, MD, MPH, 12631 East 17th Avenue, Room 7609, University of Colorado Denver, Aurora, Colorado 80045. fax: (303) 724-1858
Conflicts of interest The authors disclose no conflicts. The sponsors were not involved in the data collection, data analysis, or data interpretation in preparing this manuscript.
Funding This research was supported by a research grant from the Atkins Foundation, the University of North Carolina Gastrointestinal Biopsychosocial Research Center (National Institutes of Health R24 DK067674), and in part by a grant from the National Institutes of Health (T32 DK 07634). Facility support for this study has been provided by the University of North Carolina General Clinical Research Center.
ABSTRACT
A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome