Lactose-intolerant IBS patients benefit from a lactose-free diet, and patients with fructose malabsorption or intolerance, should exclude fructose from diet. Some patients with IBS-D report exacerbation of symptoms by certain foods and try exclusion diets. This situation is considered a food sensitivity and not a true food allergy. The study of Atkinson et al. remains the largest on this topic. IBS patients received either an elimination diet [based on the presence of high levels of food-specific Immunoglobulin G (IgG) antibodies that were interpreted as indicating food hypersensitivity] or a sham diet. A small reduction in symptom severity was observed in the 'true' elimination diet group, with a worsening of symptoms once the eliminated foods were reintroduced. Recent small studies also reported favorable results on gastrointestinal symptoms using this strategy. However, there is insufficient objective data to routinely recommend IgG antibody testing.
Curr Opin Gastroenterol. 2021;37(2):152-157. © 2021 Lippincott Williams & Wilkins