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Fermentation May Be At Root Of Irritable Bowel Syndrome LONDON, ENGLAND -- Oct. 9, 1998 -- Irritable bowel syndrome (IBS) is one of the most common reasons that people go to see a gastroenterologist. People with this disorder experience intermittent bouts of abdominal pain, usually accompanied by diarrhoea or constipation. About half of patients with IBS report that certain foods make their symptoms worse. Why this might be so is unknown, but one theory is that these foods contain substances easily fermented by the bacteria normally found in the colon. To find out, Dr. T. S. King and colleagues from Cambridge, England, recruited 12 women to participate in an experiment. The results of the study appear in this week’s issue of The Lancet. Six of the women had IBS, and six had no gastrointestinal difficulties. All women adhered to two different diets, each for two weeks. One diet was a standard diet with normal western foods. The second was a diet often prescribed to IBS patients, which sometimes helps reduce their symptoms. This diet excludes beef, dairy products, all cereals except rice and restricts the consumption of foods with yeast, citrus fruits, caffeinated drinks and tap water. On the last day of each two-week diet, the women spent 24 hours under a plastic canopy allowing the investigators to sample the gases they produced, such as hydrogen and methane. Breath samples, which can be used to monitor a person's gas production, were also taken every 30 minutes during waking hours. All faeces passed during the final 72 hours of the diet were collected and analysed. Dr King and colleagues report that while on the standard diet, both groups of women produced about the same amount of gas. However, the IBS women produced more hydrogen and produced gas more rapidly, indicating an increase in fermentation. "In four of the six [IBS] patients, symptoms occurred when gas excretion was rapid," the investigators write. These patients were then put on the restricted diet and the rate at which they produced gas fell dramatically and their symptoms improved. Although it is unlikely that the gas alone causes discomfort, the investigators explained, it may be that other chemicals produced by fermentation are to blame, producing the symptoms either by causing local effects in the bowel, or perhaps affecting the nervous system. Related Links: The Lancet E-mail this page to a friend or colleague! To print, use this version