Patients' experiences and effects of dietary changes when living with irritable bowel syndrome - Various impacts of dietary treatment

Abstract

Irritable bowel syndrome (IBS) is a complex disorder of gut-brain interaction. The causal explanations for this condition remain unclear, however, dietary factors appear to play a significant role in symptom generation and alleviation for these patients. The aim of this thesis was to gain more knowledge about the role of diet concerning the severity of IBS symptoms and the patients' perceived experiences to implement the requested dietary changes to achieve alleviation in IBS. In Paper I, we compared two restrictive dietary treatments and medical treatment for patients with IBS in a 4-week randomized controlled trial (RCT) including 294 participants. Although all three treatments showed significant alleviation in the severity of IBS symptoms, both dietary groups showed a more pronounced effect than in the medical treatment. The dietary groups also presented a lasting effect on improvements in gastrointestinal (GI), extraintestinal, and psychological symptoms over 6 months. In Paper II, inductive content analysis was used to investigate the participants' experience of implementing the dietary changes included in the dietary treatments in the RCT (Paper I). Three themes describe the dietary changes as Supportive, educational, and motivating, Multidimensional challenges, and Reflective and developing. The need for support to initiate the dietary changes became clear. Despite structured support, the dietary changes were experienced as challenges and were related to the participants' personal life situation. Going through the dietary changes started a process that resulted in more than a reduction in the severity of GI symptoms, it also gave new knowledge and diet-related reflections, and where maintained dietary changes were related to what was perceived to be practical and healthy habits. In summary, the results from this thesis confirm that diet plays an important role in the treatment of IBS. Restrictive dietary treatments reduce the burden of symptoms in IBS. With the support to implement the dietary changes for patients with IBS, a process can be initiated that leads to individualized adjusted dietary changes that are varied and can be maintained in the long term.