Low intake of vitamin B6 is associated with irritable bowel syndrome symptoms
Introduction
Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal disorder, with a prevalence of 5% to 11% [1], and is associated with high costs of health care and reduced quality of life [2].
Two thirds of subjects with IBS relate their symptoms to the intake of food, leading most patients to modify their diet, some to such a degree that their diet is inadequate [3], [4]. Previous studies have examined the diets of patients with IBS and compared them with those of control subjects [5], [6], [7]. Intolerance to and reduced intake of milk, eggs, fruits, vegetables, and cereals, along with a high intake of soft drinks and fast food, has been reported [4], [5]. Short-chain poorly absorbed carbohydrates in the diet have been shown to prolong gas production, and reduction of these carbohydrates in the diet relieved symptoms [8], [9].
The dietary recommendations for subjects with IBS include avoiding insoluble and gas-producing food items including short-chain poorly absorbed carbohydrates [10], [11], [12]. There are, to our knowledge, no studies on associations between types and amounts of foods and nutrients in the diet and the severity of symptoms in subjects with IBS. This study, with a precise registration of symptoms and dietary intake every day during a 1-week period, hypothesized that there are associations between symptoms and the intake of specific food groups and nutrients in subjects with IBS. The objective was to search for possibilities to improve the dietary treatment of the disorder.
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Subjects
Subjects were recruited consecutively from a hospital-based gastroenterology outpatient clinic and a private gastroenterologic practice. Individuals aged 18 to 75 years who were diagnosed with IBS according to the Rome II criteria and had demonstrated symptoms during the previous 3 months were eligible for inclusion. All subjects had undergone a sigmoidoscopy or colonoscopy within the previous 5 years, biopsies were taken when appropriate, and a laboratory screening was performed according to
Results
Twenty-eight subjects were recruited between January and April 2006. Of these, 5 did not meet the inclusion criteria for the randomized controlled trial, 4 withdrew consent, 1 was unable to be contacted, and 1 was excluded for other reasons. Therefore, data from 17 participants were available for this study. Of these, 1 had constipation-predominant IBS, 9 had alternating IBS, and 7 had diarrhea-predominant IBS. The daily IBS sum score was 6.43 (3.86-9.09).
Table 1 shows the subject
Discussion
The study supports the hypothesis that there are associations between symptoms and the intake of specific food groups and nutrients in subjects with IBS. There was a significant inverse association between dietary intake of B6 and severity of IBS symptoms. To our knowledge, this association has previously not been reported. Intake of B6 was inversely associated not only with IBS sum score but also with each of the symptoms in the sum score. The intake of B6 was low compared with both NNR and
Acknowledgments
We thank Ole Breder, specialist in internal medicine, for his assistance in recruiting participants. The study was funded by Nortura BA, Norway, and the Norwegian Foundation for Health and Rehabilitation through the Norwegian Asthma and Allergy Association, Norway. The funding sources had no role in the study design, data collection, analysis, interpretation of data, or in writing the manuscript.
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