Elimination Diets for Irritable Bowel Syndrome: Approaching the End of the Beginning

Dietary interventions have become a mainstay of treating patients with irritable bowel syndrome (IBS). Most of the available studies have focused on the benefits of elimination diets. While elimination diets can be highly effective, they should be avoided in patients with 2 emerging eating disorders: orthorexia nervosa and avoidant/restrictive food intake disorder. Similar to drug therapies, diet interventions are effective for only a subgroup of patients with IBS. They should be viewed as a therapy not the therapy for patients with IBS. It will be critical to develop strategies that utilize symptoms combined with biomarkers which parse patients with IBS by pathophysiology and in so doing, help providers to pick the right treatment for the right patient. At present, diet interventions are primarily focused on elimination of certain foods but there are an increasing number of supplementation studies which are lending support to the concept of functional foods.