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TOPLINE:

An elimination diet guided by a novel irritable bowel syndrome (IBS)–specific immunoglobulin G (IgG) assay reduced abdominal pain in a greater proportion of patients with IBS than a sham elimination diet.

METHODOLOGY:

• An elimination diet targeting foods that cause elevated IgG levels shows promise for managing IBS; however, studies on its efficacy have had methodological limitations (eg, lack of control arms) and produced mixed results.
• Researchers conducted a clinical trial to test the efficacy of an elimination diet based on a novel IBS-specific IgG assay in patients with IBS aged ≥ 21 years who had a 2-week average abdominal pain intensity score between 3.0 and 7.5 and tested positive for at least one food on the 18-food IgG assay.
• Patients were randomly assigned to either an experimental group following an IgG-guided diet or a sham group on a sham diet for 8 weeks; the experimental group removed foods for which they tested positive on the IgG assay, whereas the sham group eliminated foods similar to the ones for which they tested positive.
• The primary outcome was a ≥ 30% decrease in abdominal pain intensity for at least 2 of the last 4 weeks of the 8-week treatment period.

TAKEAWAY:

• Researchers randomized 118 patients to the experimental diet (mean age, 39.5 years; 76.3% women) and 105 to the sham diet (mean age, 40.7 years; 81.0% women).
• A significantly greater proportion of patients following the IgG-guided elimination diet achieved the primary endpoint of reduced abdominal pain than those on the sham diet (59.6% vs 42.1%; P = .02).
• Subgroup analysis revealed higher response rates in patients with constipation-predominant IBS (67.1% vs 35.8%) and IBS with mixed bowel habits (66.0% vs 29.5%) in the experimental group than in the sham group.
• The number of adverse events was slightly higher in the sham group than in the experimental group (2.5% vs 7.6%).

IN PRACTICE:

“Our diets are complex and identifying dietary triggers can be difficult. This IBS-specific IgG test can help patients who suffer from IBS identify specific dietary triggers,” one of the authors said in a press release.

SOURCE:

The study was led by Prashant Singh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan. It was published online in Gastroenterology.

LIMITATIONS:

Diet compliance was assessed using simple yes/no responses rather than through detailed food diaries or recalls. The study was not adequately powered for the analysis based on IBS subtype. The diets of the experimental and sham groups may have differed in fermentable oligosaccharide, disaccharide, monosaccharide, and polyol and fiber contents.

DISCLOSURES:

This study was funded by Biomerica Inc. Some authors disclosed serving as consultants or receiving funding from the funding agency and other pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.