{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:09:03Z","timestamp":1784203743659,"version":"3.55.0"},"reference-count":46,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T00:00:00Z","timestamp":1642377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2018-02566"],"award-info":[{"award-number":["2018-02566"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ALF-agreement","award":["ALFGBG-722331, ALFGBG-726561"],"award-info":[{"award-number":["ALFGBG-722331, ALFGBG-726561"]}]},{"name":"Faculty of Medicine, University of Gothenburg","award":["\/"],"award-info":[{"award-number":["\/"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: Predictors of dietary treatment response in irritable bowel syndrome (IBS) remain understudied. We aimed to investigate predictors of symptom improvement during the low FODMAP and the traditional IBS diet for four weeks. (2) Methods: Baseline measures included faecal Dysbiosis Index, food diaries with daily energy and FODMAP intake, non-gastrointestinal (GI) somatic symptoms, GI-specific anxiety, and psychological distress. Outcomes were bloating, constipation, diarrhea, and pain symptom scores treated as continuous variables in linear mixed models. (3) Results: We included 33 and 34 patients on the low FODMAP and traditional IBS diet, respectively. Less severe dysbiosis and higher energy intake predicted better pain response to both diets. Less severe dysbiosis also predicted better constipation response to both diets. More severe psychological distress predicted worse bloating response to both diets. For the different outcomes, several differential predictors were identified, indicating that baseline factors could predict better improvement in one treatment arm, but worse improvement in the other treatment arm. (4) Conclusions: Psychological, nutritional, and microbial factors predict symptom improvement when following the low FODMAP and traditional IBS diet. Findings may help individualize dietary treatment in IBS.<\/jats:p>","DOI":"10.3390\/nu14020397","type":"journal-article","created":{"date-parts":[[2022,1,17]],"date-time":"2022-01-17T20:46:03Z","timestamp":1642452363000},"page":"397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Predictors of Symptom-Specific Treatment Response to Dietary Interventions in Irritable Bowel Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5821-6723","authenticated-orcid":false,"given":"Esther","family":"Colomier","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"},{"name":"Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Van Oudenhove","sequence":"additional","affiliation":[{"name":"Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for GI Disorders, KU Leuven, 3000 Leuven, Belgium"},{"name":"Cognitive & Affective Neuroscience Lab (CANlab), Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Tack","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"B\u00f6hn","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Bennet","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"},{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Queen\u2019s University, Kingston, ON K0G 1E0, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanna","family":"Nybacka","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-846X","authenticated-orcid":false,"given":"Stine","family":"St\u00f6rsrud","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"\u00d6hman","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"T\u00f6rnblom","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-1313","authenticated-orcid":false,"given":"Magnus","family":"Simr\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden"},{"name":"Center for Functional GI and Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1053\/j.gastro.2020.04.014","article-title":"Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study","volume":"160","author":"Sperber","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV","volume":"4","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.1111\/j.1572-0241.2001.05336.x","article-title":"Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome","volume":"96","author":"Chang","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1136\/gutjnl-2016-312361","article-title":"Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders: Consistent findings from five different patient cohorts","volume":"67","author":"Palsson","year":"2018","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1038\/ajg.2012.5","article-title":"Colonic transit time and IBS symptoms: What\u2019s the link?","volume":"107","author":"Sadik","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"293-e82","DOI":"10.1111\/j.1365-2982.2009.01442.x","article-title":"Lower functional gastrointestinal disorders: Evidence of abnormal colonic transit in a 287 patient cohort","volume":"22","author":"Manabe","year":"2010","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1038\/nrgastro.2010.4","article-title":"Pathogenesis of IBS: Role of inflammation, immunity and neuroimmune interactions","volume":"7","author":"Ohman","year":"2010","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1038\/nrgastro.2014.200","article-title":"Crosstalk at the mucosal border: Importance of the gut microenvironment in IBS","volume":"12","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1053\/j.gastro.2017.06.051","article-title":"Vasoactive Intestinal Polypeptide and Mast Cells Regulate Increased Passage of Colonic Bacteria in Patients with Irritable Bowel Syndrome","volume":"153","author":"Bednarska","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1053\/j.gastro.2016.09.049","article-title":"Identification of an Intestinal Microbiota Signature Associated with Severity of Irritable Bowel Syndrome","volume":"152","author":"Tap","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1053\/j.gastro.2016.02.028","article-title":"The Intestinal Microenvironment and Functional Gastrointestinal Disorders","volume":"150","author":"Barbara","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1159\/000051878","article-title":"Food-related gastrointestinal symptoms in the irritable bowel syndrome","volume":"63","author":"Langkilde","year":"2001","journal-title":"Digestion"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/ajg.2013.105","article-title":"Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life","volume":"108","author":"Bengtsson","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1177\/2050640613501817","article-title":"Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls","volume":"1","author":"Posserud","year":"2013","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Melchior, C., Algera, J., Colomier, E., T\u00f6rnblom, H., Simr\u00e9n, M., and St\u00f6rsrud, S. Food Avoidance and Restriction in Irritable Bowel Syndrome: Relevance for Symptoms, Quality of Life and Nutrient Intake. Clin. Gastroenterol. Hepatol., 2021. in press.","DOI":"10.1016\/S0016-5085(21)02164-8"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Algera, J., Colomier, E., and Simr\u00e9n, M. (2019). The Dietary Management of Patients with Irritable Bowel Syndrome: A Narrative Review of the Existing and Emerging Evidence. Nutrients, 11.","DOI":"10.3390\/nu11092162"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/jhn.12385","article-title":"British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update)","volume":"29","author":"McKenzie","year":"2016","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1136\/bmj.39484.712616.AD","article-title":"Diagnosis and management of irritable bowel syndrome in adults in primary care: Summary of NICE guidance","volume":"336","author":"Dalrymple","year":"2008","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1111\/j.1365-2036.2010.04237.x","article-title":"Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon","volume":"31","author":"Barrett","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.gastro.2013.09.046","article-title":"A diet low in FODMAPs reduces symptoms of irritable bowel syndrome","volume":"146","author":"Halmos","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/j.1365-277X.2011.01162.x","article-title":"Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome","volume":"24","author":"Staudacher","year":"2011","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/ijcp.12128","article-title":"The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: A prospective study","volume":"67","author":"Dobbs","year":"2013","journal-title":"Int. J. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1053\/j.gastro.2015.07.054","article-title":"Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: A randomized controlled trial","volume":"149","author":"Liljebo","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1111\/jgh.15573","article-title":"Better response to low FODMAP diet in disorders of gut-brain interaction patients with pronounced hydrogen response to a nutrient challenge test","volume":"36","author":"Schindler","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.cgh.2017.09.055","article-title":"Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome","volume":"16","author":"Rossi","year":"2018","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4414","DOI":"10.1016\/j.clnu.2020.12.041","article-title":"Methane and fatty acid metabolism pathways are predictive of Low-FODMAP diet efficacy for patients with irritable bowel syndrome","volume":"40","author":"Eetemadi","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1093\/ajcn\/nqab005","article-title":"Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: A parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomes","volume":"113","author":"Zhang","year":"2021","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1136\/gutjnl-2016-313128","article-title":"Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs","volume":"67","author":"Bennet","year":"2018","journal-title":"Gut"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s10620-017-4893-3","article-title":"Exploring Gut Microbiota Composition as an Indicator of Clinical Response to Dietary FODMAP Restriction in Patients with Irritable Bowel Syndrome","volume":"63","author":"Valeur","year":"2018","journal-title":"Dig. Dis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Vervier, K., Moss, S., Kumar, N., Adoum, A., Barne, M., Browne, H., Kaser, A., Kiely, C.J., Neville, B.A., and Powell, N. (2021). Two microbiota subtypes identified in irritable bowel syndrome with distinct responses to the low FODMAP diet. Gut, preprint.","DOI":"10.1101\/2021.05.14.444142"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1136\/gutjnl-2014-307264","article-title":"Diets that differ in their FODMAP content alter the colonic luminal microenvironment","volume":"64","author":"Halmos","year":"2015","journal-title":"Gut"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e13619","DOI":"10.1111\/nmo.13619","article-title":"Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses","volume":"31","author":"Midenfjord","year":"2019","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1053\/j.gastro.2005.11.061","article-title":"Functional bowel disorders","volume":"130","author":"Longstreth","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1046\/j.1365-2036.1997.142318000.x","article-title":"The irritable bowel severity scoring system: A simple method of monitoring irritable bowel syndrome and its progress","volume":"11","author":"Francis","year":"1997","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1080\/00365520310004209","article-title":"An irritable bowel syndrome-specific symptom questionnaire: Development and validation","volume":"38","author":"Wiklund","year":"2003","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/ajg.2013.96","article-title":"Short-chain carbohydrates and functional gastrointestinal disorders","volume":"108","author":"Shepherd","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Liljebo, T., St\u00f6rsrud, S., and Andreasson, A. (2020). Presence of Fermentable Oligo-, Di-, Monosaccharides, and Polyols (FODMAPs) in commonly eaten foods: Extension of a database to indicate dietary FODMAP content and calculation of intake in the general population from food diary data. BMC Nutr., 6.","DOI":"10.1186\/s40795-020-00374-3"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/00006842-200203000-00008","article-title":"The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms","volume":"64","author":"Kroenke","year":"2002","journal-title":"Psychosom. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1365-2036.2004.02007.x","article-title":"The Visceral Sensitivity Index: Development and validation of a gastrointestinal symptom-specific anxiety scale","volume":"20","author":"Labus","year":"2004","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/apt.13236","article-title":"Deviations in human gut microbiota: A novel diagnostic test for determining dysbiosis in patients with IBS or IBD","volume":"42","author":"Sekelja","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1002\/sim.7279","article-title":"Interpretable inference on the mixed effect model with the Box-Cox transformation","volume":"36","author":"Maruo","year":"2017","journal-title":"Stat. Med."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Harris, L.R., and Roberts, L. (2008). Treatments for irritable bowel syndrome: Patients\u2019 attitudes and acceptability. BMC Complement. Altern. Med., 8.","DOI":"10.1186\/1472-6882-8-65"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/apt.13706","article-title":"Randomised clinical trial: The efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome","volume":"44","author":"Peters","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Sloan, T.J., Jalanka, J., Major, G.A.D., Krishnasamy, S., Pritchard, S., Abdelrazig, S., Korpela, K., Singh, G., Mulvenna, C., and Hoad, C.L. (2018). A low FODMAP diet is associated with changes in the microbiota and reduction in breath hydrogen but not colonic volume in healthy subjects. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201410"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1053\/j.gastro.2017.06.010","article-title":"A Diet Low in FODMAPs Reduces Symptoms in Patients with Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial","volume":"153","author":"Staudacher","year":"2017","journal-title":"Gastroenterology"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/2\/397\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:02:53Z","timestamp":1760133773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/2\/397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,17]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["nu14020397"],"URL":"https:\/\/doi.org\/10.3390\/nu14020397","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,17]]}}}