Medically reviewed by Onikepe Adegbola, MD, PhD
Several treatment options exist in the literature for patients diagnosed with irritable bowel syndrome (IBS) to help manage their uncomfortable symptoms and improve their overall quality of life. However, a debate exists between medication management and diet management advocacy.
A cohort of researchers from KU Leuven University led a study to compare the efficacy of a low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet with otilonium bromide, a spasmolytic, medication management in individuals with IBS in Europe. The study demonstrated that the low FODMAP diet was more effective within the primary care system in improving IBS symptoms compared to the otilonium bromide.
The study, “Diet or medication in primary care patients with IBS: the DOMINO study – a randomized trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute,” was recently published in Gut in April 2022.
In this randomized controlled control, 459 patients with IBS were assigned to complete either an eight-week treatment of otilonium bromide medication or the low FODMAP diet. The participants were then followed up for 24 weeks for observation and analysis. Within the low FODMAP diet treatment group, 94% of participants followed the diet for eight weeks—however, only 73% of the medication group adhered to the treatment for the entirety of the research period.
In addition to studying participants’ symptom severity and compliance, researchers also examined measures evaluating the quality of life, depression, anxiety, et cetera. Considering all contributing factors, researchers concluded that the superiority of the low FODMAP diet as the first line of action for treating patients with IBS.
Carbone, F., Van den Houte, K., Besard, L., Tack, C., Arts, J., Caenepeel, P., Piessevaux, H., Vandenberghe, A., Matthys, C., Biesiekierski, J., Capiau, L., Ceulemans, S., Gernay, O., Jones, L., Maes, S., Peetermans, C., Raat, W., Stubbe, J., Van Boxstael, R., Vandeput, O., … Domino Study Collaborators (2022). Diet or medication in primary care patients with IBS: the DOMINO study – a randomized trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut, gutjnl-2021-325821. Advance online publication. https://doi.org/10.1136/gutjnl-2021-325821