the effectiveness of low-carb diets has been confirmed

This is new evidence that diet plays a central role in irritable bowel syndrome (or “functional colopathy”). A study recently published in the journal Lancet Gastroenterology and Hepatology confirms that a diet low in Fodmaps (an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols) is effective in improving symptoms and quality of life in patients. This study even proves for the first time that this diet is more effective than medications. Let us remember that this benign disease, which affects 5% of the population (more women than men), causes intestinal disorders and abdominal pain every day.

To reach this conclusion, researchers from the University of Gothenburg in Sweden tested three types of treatments on 300 patients over a month. The first group had to follow a diet low in Fodmaps, that is, eliminate foods containing sugars that are poorly absorbed in the intestines. Mention may be made of lactose contained in dairy products; fructans, which are found in wheat, rye and barley; fructose, present in fruits, but also added to all industrially prepared dishes; or even galactans, which are mainly found in legumes (chickpeas, lentils, etc.).

Long-term benefits

The second group followed a “low-carb” diet: low in carbohydrates but high in protein. Patients of the third group, in turn, received antispasmodic, laxative or antidiarrheal drugs. After one month of treatment, all three groups had improved symptoms and quality of life. But not in the same proportions: three-quarters of the patients on one of the two diets improved, compared with “only” half of the people on the medication.

The benefits of the diets were even felt over time, with most participants feeling well after six months, although they gradually returned to their normal diet. “ This finding suggests that small reductions in food and carbohydrate intake may have a beneficial effect. »the authors of the study emphasize.

In practice, a diet low in Fodmaps is already recommended for the treatment of irritable bowel syndrome, but not a low-carbohydrate diet rich in protein, for which there is no evidence of effectiveness. “ The low Fodmaps diet involves temporarily eliminating all foods that contain fermentable sugars as they increase water secretion in the small intestine, leading to bloating, and ferment them in the colon, resulting in gas. »– explains P.^R Benoit Coffin, Head of the Department of Hepato-Gastroenterology at the Louis-Mourier Hospital in Colombes (Haute-Seine). Retained water and gases cause the digestive tract to stretch, causing pain.

Irritable bowel syndrome occurs as a result of hypersensitivity of the gut-brain axis, and fermentable sugars exacerbate this phenomenon.

Professor François Mion, Head of the Department of Functional Digestive Research at the Edouard-Herriot Hospital in Lyon.

“ Many patients think that they have an intolerance or allergy to a particular food, especially gluten, but this is not the case. »– clarifies P.^R François Mion, head of the functional research department of digestion at the Edouard-Herriot hospital in Lyon. “ Irritable bowel syndrome occurs as a result of hypersensitivity of the gut-brain axis, and fermentable sugars exacerbate this phenomenon. »he continues.

Foods to be introduced gradually

On paper, the idea is simple: remove Fodmaps sources completely for six to eight weeks. “ If the patient gets better, he is asked to gradually reintroduce different food groups so that he can determine if they are acceptable doses for him. »points to P^R Francois Mion. The first effects usually begin to be felt within one to two weeks. But in reality, eliminating these sugars from our diet is a big challenge. “ This diet is difficult to follow because it contains so many foods. : lots of fruits and vegetables, all wheat products, industrial dishes… »lists the gastroenterologist.

Fortunately, there are alternatives. Instead of milk and yoghurts, you should, for example, switch to lactose-free milk, plant-based drinks (soy, oats, etc.) or even soy yoghurts. As for fruits, apples, pears, peaches or even apricots should give way to bananas, pineapples, citrus fruits or even melon. “ You should also eliminate all foods made from wheat, barley and rye, as they contain starch that is resistant to digestion. »– clarifies P.^R Benoit Coffin. Goodbye, therefore, pasta, semolina, flour, bread, cereals. “ Buckwheat, spelt, rice or oats in all their forms can replace wheat products. »states P.^R Mion.

Get support from a nutritionist

“ This is a diet that works well and is prescribed very often, it is worth trying. »calls P.^R Coffin, while acknowledging the limitations this presents. Moreover, avoiding all these fermentable carbohydrates can lead to an unbalanced diet and cause deficiency. Therefore, ideally, you should seek help from a dietitian or nutritionist, especially if you are prone to eating disorders.

“ This is not easy because you need to find a professional who knows this disease well and you must have enough income to afford this treatment since it is not covered by insurance. »emphasizes the letter P^R Francois Mion. However, in several cities (Lyon, Paris, Rouen, Nancy, Bordeaux, etc.), hospitals have created reimbursement treatment schemes where you can do everything at once: medical consultation, dietary sessions and psychological support. But you will have to be patient. “ In our hospital, the waiting time is three to four months. »– clarifies P.^R Mion.