The Sourdough School

BALM – Proven as one of the healthiest approaches to bread in the world.

Based in the walled gardens of Dr. Vanessa Kimbell's beautiful Victorian home in rural Northamptonshire, UK, we tutor individuals and train bakers and healthcare professionals in Baking as Lifestyle Medicine (BALM). Personalising bread to your lifestyle, gut microbiome, and unique genetics for optimal health—tailoring fermentation, fibre, and diversity so that your daily bread becomes the foundation of your health.

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102 - ‘Dietary Triggers of Abdominal Symptoms in Patients With Irritable Bowel Syndrome: Randomized Placebo-Controlled Evidence’. Clinical Gastroenterology and Hepatology. 6, Issue 7, (765–771)

Reference Number: 102

Year: 2008

Authors: Susan J. Shepherd, Francis C. Parker, Jane G. Muir, Peter R. Gibson

Link: Link to original paper

Health: IBS

Intolerance & Sensitivity: FODMAPS

Summary

Introduction

Observational studies suggest dietary fructose restriction might lead to sustained symptomatic response in patients with irritable bowel syndrome (IBS) and fructose malabsorption.

Aims

The aims of this study were first to determine whether the efficacy of this dietary change is due to dietary fructose restriction and second to define whether symptom relief was specific to free fructose or to poorly absorbed short-chain carbohydrates in general.

Methods

The double-blinded, randomized, quadruple arm, placebo-controlled rechallenge trial took place in the general community. The 25 patients who had responded to dietary change were provided all food, low in free fructose and fructans, for the duration of the study. Patients were randomly challenged by graded dose introduction of fructose, fructans, alone or in combination, or glucose taken as drinks with meals for maximum test period of 2 weeks, with at least 10-day washout period between. For the main outcome measures, symptoms were monitored by daily diary entries and responses to a global symptom question.

Results

Seventy percent of patients receiving fructose, 77% receiving fructans, and 79% receiving a mixture reported symptoms were not adequately controlled, compared with 14% receiving glucose. Similarly, the severity of overall and individual symptoms was significantly and markedly less for glucose than other substances. Symptoms were induced in a dose-dependent manner and mimicked previous IBS symptoms.

Conclusion

In patients with IBS and fructose malabsorption, dietary restriction of fructose and/or fructans is likely to be responsible for symptomatic improvement, suggesting efficacy is due to restriction of poorly absorbed short-chain carbohydrates in general.

 

SIGNIFICANCE OF THIS STUDY

This study provides us with an overview of what might be the dietary trigger for the onset of IBS associated symptoms. The study states that lowering the intake of FODMAPs such as fructans (oligosaccharides present in a variety of foods including cereal grains) have proven helpful in improving IBS symptoms. This is because short chain carbohydrates (called oligosaccharides) such as fructans are poorly broken down and absorbed by people suffering from IBS therefore triggering symptoms such as bloating, abdominal pain and discomfort etc. Restricting the intake of short chain carbohydrates or following a low FODMAP diet is important to manage these symptoms.

Take a look at our courses at The Sourdough School

All reasonable care is taken when advising about health aspects of bread, but the information that we share is not intended to take the place of treatment by a qualified medical practitioner. You must seek professional advice if you are in any doubt about any medical condition. Any application of the ideas and information contained on this website is at the reader's sole discretion and risk.

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