Tj. Parker et al., MANAGEMENT OF PATIENTS WITH FOOD INTOLERANCE IN IRRITABLE-BOWEL-SYNDROME - THE DEVELOPMENT AND USE OF AN EXCLUSION DIET, Journal of human nutrition and dietetics, 8(3), 1995, pp. 159-166
Food intolerance is an important cause of abdominal symptoms. As no ob
jective tests are available to identify the foods concerned, diets are
essential for the management of these patients. The fewer foods allow
ed in the diet, the greater is the chance of success. Our original stu
dies of 182 patients between 1979 and 1982, using a diet of lamb, rice
and pears, had resulted in a 67% success rate. The foods most commonl
y involved were wheat (60%), cows' milk (44%) and corn (44%). A less r
estrictive exclusion diet was developed from the results of this work,
avoiding all those foods to which 20% or more of the patients had bee
n intolerant. Of 253 patients (79%), 200 were able to complete 2 weeks
on this diet and 100 (50%) were successful in controlling their sympt
oms. The exclusion diet was modified in the light of this experience a
nd in a subsequent study of 129 patients, 96 (75%) were able to comply
for 2 weeks, but only 39 (41%) improved on the basic diet. However, e
xamination of the food diaries of these patients enabled the identific
ation of less frequent food intolerances in 21 (22%) giving an overall
success rate of 60 (63%). In this way, equally good results can be ob
tained using a nutritionally adequate exclusion diet and avoiding the
difficulties of following a more rigorous elimination regime.