British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults


Y. McKenzie, Nuffield Health The Manor Hospital, Beech Road, Headington, Oxford OX3 7RP, UK.
Tel.: +44 079 66 87 8758
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How to cite this article: McKenzie Y.A., Alder A., Anderson W., Wills A., Goddard L., Gulia P., Jankovich E., Mutch P., Reeves L.B., Singer A. & Lomer M.C.E. on behalf of Gastroenterology Specialist Group of the British Dietetic Association. (2012) British Dietetic Association evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults. J Hum Nutr Diet
. 25, 260–274


Background:  Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians.

Methods:  Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed.

Results:  Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. First line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials.

Conclusions:  These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS.