Although a strict gluten free diet in the absence of coeliac disease should not be started, a reduction of gluten content might be a valid option in individuals with irritable bowel syndrome

In December 2018 researchers from Italy published the results of their study to compare the effect of sourdough fermented products with traditional bread and pasta in individuals with irritable bowel syndrome. The researchers stated that fungal proteases and selected sourdough lactic acid bacteria have been used to produce wheat bread and pasta which contains a gluten content of under 50% of traditional products. A total of 100 individuals (aged over 18 years), with bowel symptoms, eg altered bowel habit, lower abdominal pain, bloating, or distention suggestive of irritable bowel syndrome, were involved in the study. Each individual was then started on a gluten-free diet following which they then consumed either a “normal” diet or a “reduced gluten” diet for a two week period and then after a week’s break, switched to the alternate diet. A “normal” diet was defined as a gluten free diet plus 100 g of normal gluten pasta and 200 g of normal gluten bread per day, whereas the “reduced gluten” diet was defined as a gluten free diet plus 100 g of reduced gluten pasta and 200 g of reduced gluten bread per day. Each individual underwent assessment and given scores for severity of irritable bowel syndrome, anxiety, depression and quality of life at the start of the study and after each phase of the study. Results showed that compared to the start of the study, all individuals showed an improvement in at least one of the symptoms of irritable bowel syndrome after two weeks of a gluten free diet. In addition there was a significant decrease in the irritable bowel syndrome severity score with an improvement also being seen in the anxiety, depression and quality of life scores. As expected, the administration of normal-gluten bread and pasta increased the symptoms of irritable bowel syndrome in all individuals compared to the gluten free diet. However, compared to the “normal” gluten diet, the administration of a “reduced gluten” diet resulted in a decrease of the irritable bowel syndrome severity score, although no differences were found in the anxiety, depression and quality of life scores. The researchers stated that although a strict gluten free diet in the absence of coeliac disease should not be started, a reduction of gluten content might be a valid option in individuals with irritable bowel syndrome.

Calasso M et al. New Protocol for Production of Reduced-Gluten Wheat Bread and Pasta and Clinical Effect in Patients with Irritable Bowel Syndrome: A randomised, Double-Blind, Cross-Over Study. Nutrients. 2018 Dec 2;10(12). pii: E1873.

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