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25-04-2024 | Irritable Bowel Syndrome | Original Article

Coffee, Alcohol, and Artificial Sweeteners Have Temporal Associations with Gastrointestinal Symptoms

Authors: Egbert Clevers, Darren Launders, Damian Helme, Sanna Nybacka, Stine Störsrud, Maura Corsetti, Lukas Van Oudenhove, Magnus Simrén, Jan Tack

Published in: Digestive Diseases and Sciences

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Abstract

Background

Various dietary strategies for managing irritable bowel syndrome (IBS) target mechanisms such as brain–gut interactions, osmotic actions, microbial gas production, and local immune activity. These pathophysiological mechanisms are diverse, making it unclear which foods trigger IBS symptoms for a substantial proportion of patients.

Aim

To identify associations between foods and gastrointestinal symptoms.

Methods

From the mySymptoms smartphone app, we collected anonymized diaries of food intake and symptoms (abdominal pain, diarrhea, bloating, and gas). We selected diaries that were at least 3 weeks long. The diaries were analyzed for food–symptom associations using a proprietary algorithm. As the participants were anonymous, we conducted an app-wide user survey to identify IBS diagnoses according to Rome IV criteria.

Results

A total of 9,710 food symptom diaries that met the quality criteria were collected. Of the survey respondents, 70% had IBS according to Rome IV criteria. Generally, strong associations existed for caffeinated coffee (diarrhea, 1–2 h postprandial), alcoholic beverages (multiple symptoms, 4–72 h postprandial), and artificial sweeteners (multiple symptoms, 24–72 h postprandial). Histamine-rich food intake was associated with abdominal pain and diarrhea. Some associations are in line with existing literature, whilst the absence of an enriched FODMAP-symptom association contrasts with current knowledge.

Conclusions

Coffee, alcohol, and artificial sweeteners were associated with GI symptoms in this large IBS-predominant sample. Symptom onset is often within 2 h postprandial, but some foods were associated with a delayed response, possibly an important consideration in implementing dietary recommendations. Clinical trials must test the causality of the demonstrated food–symptom associations.
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Metadata
Title
Coffee, Alcohol, and Artificial Sweeteners Have Temporal Associations with Gastrointestinal Symptoms
Authors
Egbert Clevers
Darren Launders
Damian Helme
Sanna Nybacka
Stine Störsrud
Maura Corsetti
Lukas Van Oudenhove
Magnus Simrén
Jan Tack
Publication date
25-04-2024
Publisher
Springer US
Published in
Digestive Diseases and Sciences
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-024-08457-y
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