Document Type
Article
Publication Date
12-11-2024
Abstract
Introduction: Irritable bowel syndrome (IBS) is a common condition that alters the quality of life of patients. A variety of dietary interventions have been introduced to address this debilitating condition. The low-FODMAP diet (LFD), gluten-free diet (GFD), and Mediterranean diet are examples showing efficacy. The aim of this network meta-analysis was to compare these interventions to find the best approach. Methods: We performed a systematic review of the available literature through 14 March 2024 in the following databases: Embase, PubMed, MEDLINE OVID, Web of Science, CINAHL Plus, and Cochrane Central. We only included randomized controlled trials (RCTs). We used a random effects model and conducted a direct meta-analysis based on the DerSimonian-Laird approach and a network meta-analysis based on the frequentist approach. Mean differences (MDs) with 95% confidence interval (CI) were calculated. The primary outcomes included IBS quality of life (IBS QOL) and IBS symptom severity scale (IBS-SSS). Results: We finalized 23 studies including 1689 IBS patients. In the direct meta-analysis, there was no statistically significant difference in any IBS score between GFD and either LFD or standard diet. Meanwhile, the LFD was statistically superior to the standard diet in the IBS-SSS (MD: -46.29, CI: -63.72--28.86, p < 0.01) and IBS QOL (MD: 4.06, CI: 0.72-7.41, p = 0.02). On ranking, the Mediterranean diet showed the greatest improvement in IBS-SSS, IBS-QOL, distension, dissatisfaction, and general life interference, followed by the LFD alone or in combination with the GFD. Conclusions: We demonstrated the efficacy of dietary interventions such as the LFD and Mediterranean diet in improving IBS. There is a need for large RCTs with head-to-head comparisons, particularly for the Mediterranean diet.
Recommended Citation
Haghbin, Hossein; Hasan, Fariha; Gangwani, Manesh Kumar; Zakirkhodjaev, Nurruddinkhodja; Lee-Smith, Wade; Beran, Azizullah; Kamal, Faisal; Hart, Benjamin; and Aziz, Muhammad, "Efficacy of Dietary Interventions for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis" (2024). Division of Gastroenterology and Hepatology Faculty Papers. Paper 109.
https://jdc.jefferson.edu/gastro_hepfp/109
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
39768453
Language
English
Comments
This article is the author's final published version in Journal of Clinical Medicine, Volume 13, Issue 24, December 2024, Article number 7531.
The published version is available at https://doi.org/10.3390/jcm13247531.
Copyright © 2024 by the authors