Modified Rye Bread Helps Patients with Irritable Bowel Syndrome

A low FODMAP diet cuts out most fruits and grains and would not, otherwise, be recommended or considered healthy. Therefore, patients with IBS who are considering a low FODMAP diet should first discuss it with their doctor.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. It affects, on average, 11% of the adult population in the developed countries.

 

Patients with irritable bowel syndrome (IBS) are often concerned that certain foods may trigger or worsen their symptoms, which can include abdominal pain, cramps and stomach rumbling, diarrhea, constipation, and flatulence.

 

Whole grain rye bread is considered as a healthy food, mainly because of its high fiber content (11–14%). In Finland, rye is the single most important source of dietary fiber, accounting for 28–35% of fiber intake of working age adults.

 

This study aimed to determine whether a simple substitution of low-FODMAP rye bread for regular rye bread (high in FODMAPs), without any other concomitant dietary changes, affects the symptoms and gas accumulation or quality of life in IBS patients.

 

The Finnish researchers conducted a controlled cross-over study in patients from Aava Medical Center in Helsinki. The 87 participants were supplied with both regular rye bread and low-FODMAP rye bread for 4 weeks.
Symptoms were measured with a symptom severity scoring system (IBS-SSS) and visual analogue scale (VAS) assessments of individual symptoms. Quality of life was monitored. Colonic fermentation was measured by the breath hydrogen test and dietary intake by food diaries.

 

"Our study shows that reduction of FODMAP content of a major food staple, such as rye bread, may reduce some symptoms of IBS but is not enough per se to reach adequate overall symptom control in IBS. It's likely that a holistic low-FODMAP diet is needed in most cases in order to reach adequate control of overall symptoms," said nutritionist Dr. Reijo Laatikainen from University of Helsinki, lead author of the study published in Alimentary Pharmacology & Therapeutics.

 

"Low-FODMAP rye bread seems to be one way to increase fiber intake of patients with IBS. Just like the rest of the population, IBS patients tend to have a lower than recommended intake of fiber," he added.

 

The authors include: “As far as we are aware, this is the first randomized study to investigate the exclusive effect of bread in-patients with the irritable bowel syndrome. We were interested in rye bread because it seems to induce long satiety (second meal effect), offer special benefits in terms of glucose and insulin metabolism, has high-fiber content and many micronutrients, but on the other hand, is considered as a high-FODMAP grain.”

 

“More randomized studies will be needed to clarify the effects of FODMAPs in wholegrain foods, especially rye-based products and as contributory factors in IBS.”

 

Source:
R. Laatikainen et al, Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome, Alimentary Pharmacology & Therapeutics (2016). DOI: 10.1111/apt.13726