Low-FODMAP, gluten-free diets ease anxiety, boost quality of life in IBS

In patients with irritable bowel syndrome (IBS), low FODMAP* and a strict gluten-free diet (GFD) helps reduce anxiety and improve quality of life, a recent study has found.

The study included 50 IBS patients who were made to follow a low-FODMAP, strict-GFD regimen for 6 weeks. Afterwards, they were randomly allocated to one of the three following groups for the next 6 weeks: receiving 8 g/day of gluten for 2 weeks, with gluten-tolerating patients increasing to 16 g/day for 2 weeks and then 32 g/day for another 2 weeks (group A; n=25), continuing the low-FODMAP, strict-GFD regimen (group B; n=15), and receiving a gluten-containing diet (group C; n=10).

The Short-Form 36 (SF-36) Questionnaire revealed a significant increase in physical functioning in groups A and B (p<0.05). Group B participants showed significantly higher scores for role limitations due to physical health at the end of the study (p=0.02), combined with lower energy/fatigue scores (p=0.01). Bodily pain, in contrast, was lowered in GFD patients at the end of the study (p=0.002).

Of note, overall SF-36 results, as well as scores in the domains of physical functioning, role limitations due to physical health, role limitation due to emotional problems, social functioning, emotional wellbeing, bodily pain, and general health, were comparable across all three groups at the end of the study.

In terms of anxiety, as measured by the Zung self-rated anxiety scale, researchers found that continuing the GFD diet led to significantly lowered total anxiety scores in group B (p=0.005), particularly as regards its somatic manifestations such as a rapid heartbeat (p=0.046), dry and warm hands (p=0.046), and hot flushes (p=0.008). Similarly, group C patients saw an increase in nervousness (p=0.03).

“A low-FODMAP strict GFD had a significant effect on the anxiety in groups A and C and quality of life in groups A and B and these results led us to consider prescribing a low-FODMAP strict GFD as a therapeutic choice for the management of patients with IBS,” the researchers said.

*Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols