Hépato-Gastro & Oncologie Digestive


Links between food and irritable bowel syndrome with predominant constipation Volume 21, supplement 2, Septembre 2014

Hôpital Louis Mourier,
service d’hépato-gastroentérologie,
92700 Colombes,
France ;
INSERM U987 Physiopathologie et Pharmacologie Clinique de la Douleur ;
Président du Conseil Scientifique de l’APSSII (Association de Patients Souffrant du Syndrome de l’Intestin Irritable)
* Tirés à part

In IBS patients, a post-prandial increase in the severity of symptoms and a perceived intolerance to some foods are frequent. Most studies about diet and IBS do not distinguish the results according to different subtypes (IBS-C, IBS-D or IBS-A). Patients with IBS often modify their meals and of their diet: meal of small volume, increase in dietary fibre, decreased carbohydrate intake, avoidance of fat and dairy products, caffeine and alcohol. Dietary alterations secondary to IBS might be responsible for deficiency in some micronutrients that in fact are not so frequent. IBS is often associated with positive IgG to food allergens. Eviction of these alimentary allergens might improve symptoms, but food allergy constitutes a controversial issue. Patients having perceived food intolerance are often free of symptoms when they are blindly re-challenged with the suspected food. Fibre showed efficacy only in IBS with constipation. While sometimes soluble fibre improved symptoms, contrasting with non soluble fibre which may even be detrimental. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) have been involved in the pathogenesis of abdominal pain. Intolerance to lactose, fructose, sorbitol is associated with increased abdominal symptoms. A diet poor in FODMAPs can improves abdominal symptoms mainly bloating, gaz and abdominal pain patients.