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Special diet improves IBS symptoms
Wednesday 27 October 2010
Special diet improves IBS symptoms
An Australian-developed diet is proving a breakthrough for patients with irritable bowel syndrome, with mounting evidence that it helps control symptoms, an expert says.
Professor Peter Gibson, director of gastroenterology at Victoria’s Box Hill Hospital, told a conference last week that the ‘low-FODMAP’ diet — which restricts intake of certain dietary sugars — was supported by sufficiently strong evidence to recommend its widespread application.
“We have high-quality randomised controlled trial data showing it works, and studies from overseas are now showing the same efficacy,” he told Australian Doctor, adding: “We are starting to silence the sceptics who thought it was merely a placebo effect”.
While many people with IBS have tried wheat-free or dairy-free diets, Dr Gibson’s teams’ breakthrough was to consider the effects of a range of dietary sugars called FODMAPs.
They theorised that rapidly fermentable oligosaccharides, disaccharides and monosaccharides and polyols (FODMAPs) were a trigger for symptoms in patients with sensitive bowels because they produce excess gases and also draw water into the gut. The theory has been supported by a placebo-controlled blinded study of 26 patients on the diet who experienced increased symptoms when rechallenged with the sugars.
“There was a striking dose-dependent induction of symptoms with the FODMAPs, but not with placebo,” Professor Gibson said.
Although the diet was not effective in all irritable bowel syndrome patients, one study found it helped reduce symptoms in 75% of patients when delivered by a dietician, he said.
Professor Michael Grimm, president of the Gastroenterological Society of Australia, said Professor Gibson should be commended for his research, adding there was no doubt the low-FODMAP diet was helping many people with irritable bowel syndrome.
“Patients love having some control over their symptoms,” he said.
Problem high-FODMAP foods
• Apples, pears, mango, watermelon; honey (excess fructose)
• Milk — cow, goat and sheep; yoghurt; soft and fresh cheeses (lactose)
• Asparagus, beetroot, broccoli, onions; wheat and rye when eaten in large amounts; legumes (oligosaccharides)
• Sweeteners such as sorbitol, isomalt (polyols)
Suitable alternative low-FODMAP foods
• Banana, blueberry, strawberry, orange, kiwifruit; maple syrup, golden syrup
• Lactose-free milk, rice milk; ‘hard’ cheeses, brie, camembert
• Carrot, capsicum, lettuce, pumpkin, tomato, green beans; gluten-free and spelt bread and cereals
• Sucrose, glucose
Professor Gibson was awarded the Distinguished Research Prize at the Gastroenterology Week 2010 Conference on the Gold Coast last week.
The above originally appeared here.
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