Irritable bowel syndrome affects around one in ten adults and is marked by abdominal pain, bloating, and irregular bowel habits.
There is no cure, and medications often bring only limited relief.
In recent years, doctors have turned increasing attention to diet, particularly the low-FODMAP approach, which reduces hard-to-digest carbohydrates that ferment in the gut.
Previous research published in Nutrients hinted that a low-carbohydrate plan might also help.
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A Swedish study published in The Lancet Gastroenterology and Hepatology have now compared these two diets directly with standard medication to see which brings the most relief.
Comparing diet and medicine
Researchers at the University of Gothenburg enrolled nearly 300 people with moderate to severe IBS.
Participants were assigned to one of three groups: personalized medication, a low-FODMAP diet with standard IBS guidance, or a strict low-carb plan allowing about 50 grams of carbohydrates daily.
After four weeks, most participants reported improvement, but diet clearly made the biggest difference.
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About three-quarters of those on the low-FODMAP plan and seven in ten on the low-carb diet experienced meaningful relief, compared with just over half in the medication group.
The findings surprised researchers who had expected FODMAP restrictions to outperform low-carb eating by a wider margin.
Long-Term lessons and cautions
When checked six months later, many participants still felt better, even though they had relaxed their diets somewhat.
This suggests that even modest carbohydrate reduction might help control symptoms.
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Experts note, however, that restrictive diets can be difficult to sustain and may limit social eating or nutrient intake.
Doctors recommend reintroducing foods gradually and tailoring plans to each patient.
The study’s lead author, Sanna Nybacka, told The New York Times that many participants chose to return to stricter eating patterns when their symptoms flared.
While diet may not replace medication for everyone, the research points toward a future where managing IBS depends less on pills, and more on what’s on the plate.
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Sources: Forskning.no, Nutrients, and The Lancet Gastroenterology and Hepatology.
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