Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial

Abstract Background and Aim Diet is a major contributor to irritable bowel syndrome (IBS) and is also a powerful tool for treatment of IBS. This study compared two diets and explored the effectiveness of the diets when combined with a probiotic for treatment of IBS‐D patients. Methods Phase I, patie...

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Main Authors: Xian‐Shu Zhao, Li‐Jun Shi, Bao‐Li Ning, Zhi‐Ming Zhao, Xiao‐Xue Li, Meng‐Hua Zhu, Ya‐Bing Zhang, Jun Fu
Format: Article
Language:English
Published: Wiley 2023-05-01
Series:Immunity, Inflammation and Disease
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Online Access:https://doi.org/10.1002/iid3.857
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author Xian‐Shu Zhao
Li‐Jun Shi
Bao‐Li Ning
Zhi‐Ming Zhao
Xiao‐Xue Li
Meng‐Hua Zhu
Ya‐Bing Zhang
Jun Fu
author_facet Xian‐Shu Zhao
Li‐Jun Shi
Bao‐Li Ning
Zhi‐Ming Zhao
Xiao‐Xue Li
Meng‐Hua Zhu
Ya‐Bing Zhang
Jun Fu
author_sort Xian‐Shu Zhao
collection DOAJ
description Abstract Background and Aim Diet is a major contributor to irritable bowel syndrome (IBS) and is also a powerful tool for treatment of IBS. This study compared two diets and explored the effectiveness of the diets when combined with a probiotic for treatment of IBS‐D patients. Methods Phase I, patients were randomized into groups; control, cold/spicy/fried restricted diet (CSF res diet), IgG positive restricted diet (IgG res diet), and a combination both diets (CSF + IgG res diet). Phase II, patients were randomized into IgG res diet + placebo and IgG res diet + probiotic. Both interventions were 12 weeks in duration. Symptom Severity Scale (IBS‐D‐SSS) and IgG titer were assessed at the beginning and the end of the study. Results Totals of 214 and 167 patients completed the two parts of the study, respectively. After intervention, IBS‐D‐SSS and TIgG grade were significantly improved compared to baseline, with results similar to the control group. In general, there were decreases in IBS‐D‐SSS and TIgG grade that were significantly different among the groups. There were exceptions; no differences were observed for IBS‐D‐SSS between the IgG res diet and CSF + IgG res diet, or TIgG grade between the CSF res diet, IgG res diet, and CSF + IgG res diet. However, the CSF res diet and IgG res diet had a synergistic effect that decreased IBS‐D‐SSS and TIgG titer, with a greater contribution by the IgG res diet. Therefore, we evaluated the IgG res diet with either placebo or probiotic and found that IBS‐D‐SSS and TIgG grade decreased from baseline. There was a significant decrease in IBS‐D‐SSS with the probiotic but TIgG grade was not significantly different between the IgG diet + placebo and IgG diet + probiotic diet. Conclusions Both the CSF res diet and IgG res diet improved IBS symptoms and demonstrated synergy, although the IgG res diet had a greater contribution. Further, when intolerant foods cannot be eliminated from a diet, avoiding uncooked, cold, spicy, fried, and alcoholic foods is a superior choice. The IgG res diet combined with Bifidobacteria was the best dietary choice and may function though a non‐IgG pathway.
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spelling doaj-art-0254cbd7f4784d93b1bb3f5da92984092025-08-20T02:15:41ZengWileyImmunity, Inflammation and Disease2050-45272023-05-01115n/an/a10.1002/iid3.857Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trialXian‐Shu Zhao0Li‐Jun Shi1Bao‐Li Ning2Zhi‐Ming Zhao3Xiao‐Xue Li4Meng‐Hua Zhu5Ya‐Bing Zhang6Jun Fu7Health Center of Screening and Prevention of Diseases First Affiliated Hospital of Harbin Medical University Harbin ChinaDepartment of gastroenterology First Affiliated Hospital of Harbin Medical University Harbin ChinaHealth Center of Screening and Prevention of Diseases First Affiliated Hospital of Harbin Medical University Harbin ChinaHealth Center of Screening and Prevention of Diseases First Affiliated Hospital of Harbin Medical University Harbin ChinaDepartment of gastroenterology First Affiliated Hospital of Harbin Medical University Harbin ChinaDepartment of gastroenterology First Affiliated Hospital of Harbin Medical University Harbin ChinaDepartment of gastroenterology First Affiliated Hospital of Harbin Medical University Harbin ChinaHealth Center of Screening and Prevention of Diseases First Affiliated Hospital of Harbin Medical University Harbin ChinaAbstract Background and Aim Diet is a major contributor to irritable bowel syndrome (IBS) and is also a powerful tool for treatment of IBS. This study compared two diets and explored the effectiveness of the diets when combined with a probiotic for treatment of IBS‐D patients. Methods Phase I, patients were randomized into groups; control, cold/spicy/fried restricted diet (CSF res diet), IgG positive restricted diet (IgG res diet), and a combination both diets (CSF + IgG res diet). Phase II, patients were randomized into IgG res diet + placebo and IgG res diet + probiotic. Both interventions were 12 weeks in duration. Symptom Severity Scale (IBS‐D‐SSS) and IgG titer were assessed at the beginning and the end of the study. Results Totals of 214 and 167 patients completed the two parts of the study, respectively. After intervention, IBS‐D‐SSS and TIgG grade were significantly improved compared to baseline, with results similar to the control group. In general, there were decreases in IBS‐D‐SSS and TIgG grade that were significantly different among the groups. There were exceptions; no differences were observed for IBS‐D‐SSS between the IgG res diet and CSF + IgG res diet, or TIgG grade between the CSF res diet, IgG res diet, and CSF + IgG res diet. However, the CSF res diet and IgG res diet had a synergistic effect that decreased IBS‐D‐SSS and TIgG titer, with a greater contribution by the IgG res diet. Therefore, we evaluated the IgG res diet with either placebo or probiotic and found that IBS‐D‐SSS and TIgG grade decreased from baseline. There was a significant decrease in IBS‐D‐SSS with the probiotic but TIgG grade was not significantly different between the IgG diet + placebo and IgG diet + probiotic diet. Conclusions Both the CSF res diet and IgG res diet improved IBS symptoms and demonstrated synergy, although the IgG res diet had a greater contribution. Further, when intolerant foods cannot be eliminated from a diet, avoiding uncooked, cold, spicy, fried, and alcoholic foods is a superior choice. The IgG res diet combined with Bifidobacteria was the best dietary choice and may function though a non‐IgG pathway.https://doi.org/10.1002/iid3.857Bifidobacteriadiarrhea‐predominant irritable bowel syndromeIBS‐SSSIgG antibody titersprobioticrestricted diet
spellingShingle Xian‐Shu Zhao
Li‐Jun Shi
Bao‐Li Ning
Zhi‐Ming Zhao
Xiao‐Xue Li
Meng‐Hua Zhu
Ya‐Bing Zhang
Jun Fu
Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
Immunity, Inflammation and Disease
Bifidobacteria
diarrhea‐predominant irritable bowel syndrome
IBS‐SSS
IgG antibody titers
probiotic
restricted diet
title Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
title_full Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
title_fullStr Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
title_full_unstemmed Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
title_short Efficacy of diet restriction with or without probiotic for treatment of patients with IBS‐D: Phase I−II clinical trial
title_sort efficacy of diet restriction with or without probiotic for treatment of patients with ibs d phase i ii clinical trial
topic Bifidobacteria
diarrhea‐predominant irritable bowel syndrome
IBS‐SSS
IgG antibody titers
probiotic
restricted diet
url https://doi.org/10.1002/iid3.857
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