A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome.
OBJECTIVE
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.
Austin
Gregory L
GL
Division of Gastroenterology and Hepatology, University of Colorado Denver, 12631 East 17th Avenue, Room 7609, Aurora, Colorado 80045, USA. gregory.austin@uchsc.edu
Dalton
Christine B
CB
Hu
Yuming
Y
Morris
Carolyn B
CB
Hankins
Jane
J
Weinland
Stephan R
SR
Westman
Eric C
EC
Yancy
William S
WS
Drossman
Douglas A
DA
D000328:Adult; D003967:Diarrhea / Q000628:therapy*; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome