In an article published in Nutrients, researchers compared 2 dietary treatments for irritable bowel syndrome with predominant diarrhea (IBS-D): a low-FODMAPs diet (LFD) or a Tritordeum-based diet (TBD). Based on their data, investigators suggested that “LFD should be regarded as a first-line dietary approach, necessarily under the control of a dietitian, for those IBS-D patients mainly complaining of bloating, bowel habit dissatisfaction, and interference with quality of life (QOL).”

However, they noted that, “LFD raises specific issues, such as inadequate nutrient intake without constant dietitian assistance and possible alteration of gut microbiota.” As such, they posited that a TBD diet may be a “valid, equally effective alternative” in patients with IBS-D, given their promising data.

The clinical trial included 104 patients with IBS-D who were randomly assigned to 12 weeks of either LFD or TBD strategies. Primary outcomes of the trial included improvements in gastrointestinal symptoms and QOL, as measured by the IBS Severity Scoring System (IBS-SSS) questionnaire.

According to the report, both diets yielded equal improvements in the primary measures, lowering the overall score following 4 weeks, maintaining that range through the end of treatment (IBS-SSS total score change: −132.1; 95% CI: −74.9 to −189.4 and −130.5; 95% CI: −73.2 to −187.7; p <.0001 after LFD and TBD, respectively). Additionally, the investigators observed that neither LFD nor TBD appeared to modify micronutrient contents when extended for 12 weeks.

Overall, the authors advanced LFD as the preferred first-line approach, but they supported the potential efficacy of TBD for patients with IBS-D. In closing, they acknowledged that their conclusions “deserve further confirmation in studies investigating any pathophysiological and intestinal microbiota changes following the adoption of a TBD.”