An immune-assay guided diet for irritable bowel syndrome (IBS) may offer more individualized intervention and greater effectiveness in reducing symptoms than dietary interventions that are not personalized, Tal Engel, MD, stated in his oral paper presentation at the American College of Gastroenterology Scientific Meeting on October 24 in Vancouver, Canada

Dr Engel is a gastroenterologist with the Sheba Medical Center Tel Hashomer, Sackler School of Medicine, Tel Aviv University in Israel.

He explained that “insufficient patient adherence and essential need for ingredient restrictions” often limits the use of dietary therapy among patients with IBS. He and his colleagues sought to test the effectiveness of an individualized dietary intervention, “based on leukocyte activation to dietary components (Alcat, Germany), to improve patient compliance to diet modifications.”

The team conducted a randomized, double-blind trial that compared the efficacy of the Alcat diet versus a sham balanced diet over 8 weeks among patients with diarrhea-predominant IBS (IBS-D) and IBS with mixed presentation (IBS-M). The primary outcome for the trial was a reduction of ≥50 points on the IBS-severity scoring system (IBS-SSS). Among secondary outcomes were the raw scores of IBS-SSS; the Irritable Bowel Syndrome Quality of Life Questionnaire (IBS-QoL); and the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS). The researchers documented global assessment of improvement (IBS-GAI) and the IBS Global Improvement Scale (IBS-GIS).

The trial included 68 patients, including 44 with IBS-D and 24 with IBS-M.  Patients in the Alcat group had a higher median IBS-SSS score compared with controls (390 [305-435] vs. 330 [240-390], respectively, p=0.013) at baseline.

More than 85.0% (30/35) patients in the Alcat group met the primary outcome of reduction of 50 points or more on the IBS-SSS at 8 weeks, Dr Engel reported, compared with 54.5% (18/33) of patients in the control group (p=0.005). More patients in the Alcat-group also reported symptomatic improvement compared with the controls.

The Alcat diet showed greater benefit among patients who were naïve to other dietary interventions for IBS than patients among who had previously tried any other dietary therapy, he added.  

No serious adverse events were reported during follow-up.

“Immune-based personalized diet was more efficient than sham diet for reducing symptoms in IBS patients and may serve as a safe treatment option in this population,” Dr Engel concluded.

Reference:

Engel T. Immune-based personalized elimination diet for the treatment of irritable bowel syndrome: A double-blind randomized sham-controlled study. Presented at: 2023 ACG Scientific Meeting. Vancouver, Canada. October 24, 2023.