Self- reported food intolerance in Korean patients with Irritable Bowel Syndrome (IBS)

Abstract

Background/Aims: The majority of irritable bowel syndrome (IBS) patients attribute their symptoms to food, thus dietary interven- tion is considered to be an important option in the treatment of IBS. However, the food- related gastrointestinal (GI) symptoms in Korean patients with IBS have not been well evaluated. The aims of this study were to investigate the prevalence of food intolerance in Korean IBS patients and to determine the Korean food items and food groups per- ceived by patients to worsen GI symptoms. Methods: A total of 101 IBS patients, 167 symptomatic non- IBS sub- jects, and 125 control participants were enrolled in the study. All sub- jects completed a questionnaire that assessed the occurrence of GI symptoms after the intake of 119 Korean food items and also the vali- dated Rome III questionnaire for IBS. Symptom severity was assessed using the IBS symptom severity score. Results: More patients in the IBS group and the symptomatic non- IBS group reported food- related GI symptoms compared with the control group (79.2% vs 74.3% vs 44.8%, P<.001). The number of food items causing GI symptoms was also highest in patients with IBS (mean 9.3, P<.001). IBS patients reported that the most problematic food groups causing GI symptoms were fatty foods (25.0%), flour- based foods (23.8%), spicy foods (15.0%), and dairy products (15.0%). The most common Korean food items causing GI symptoms in IBS patients was milk (34.7%), followed by Korean ramen (27.7%), black bean- sauce noodles/Chinese- style noodles with vegetables and seafood (24.8%), and pork belly (24.8%). In IBS patients, 49.5% reported GI symptoms related to at least one of the food items with fermentable oligo- , di- , monosaccharides, and polyols (FODMAPs). With increasing IBS symp- tom severity, patients reported more food items causing GI symptoms (P=.020). No significant association was found between IBS subtypes and the food related GI symptoms. Conclusions: A large proportion of Korean IBS patients complained of food intolerance to certain food items, with fatty foods, flour- based foods, spicy foods, and dairy products being the main triggers. These data provide a basis for dietary recommendations for Korean IBS patients. Policy of full disclosure: None.