Gastrointestinal Issues

GERD (Acid Reflux)

A Very Low-Carbohydrate Diet Improves Gastroesophageal Reflux and Its Symptoms, Digestive Diseases and Sciences, Volume 51 Number 8 / August 2006, Gregory L. Austin et. al. Abstract excerpt:

Obese patients with gastroesophageal reflux disease (GERD) may experience resolution of symptoms utilizing a very low-carbohydrate diet. The mechanism of this improvement is unknown.

This study aimed to prospectively assess changes in distal esophageal acid exposure and GERD symptoms among obese adults initiating a very low-carbohydrate diet. We studied obese individuals with GERD initiating a diet containing less than 20 g/day of carbohydrates. Symptom severity was assessed using the GERD Symptom Assessment Scale—Distress Subscale (GSAS-ds). Participants underwent 24-hr esophageal pH probe testing and initiated the diet upon its completion. Within 6 days, a second pH probe test was performed.

Outcomes included changes in the Johnson-DeMeester score, percentage total time with a pH<4 in the distal esophagus, and GSAS-ds scores. Eight participants were enrolled. Mean Johnson-DeMeester score decreased from 34.7 to 14.0 (P=0.023). Percentage time with pH<4 decreased from 5.1% to 2.5% (P=0.022). Mean GSAS-ds score decreased from 1.28 to 0.72 (P=0.0004).

These data suggest that a very low-carbohydrate diet in obese individuals with GERD significantly reduces distal esophageal acid exposure and improves symptoms.

Irritable Bowel Syndrome

A Very Low-Carbohydrate Diet Improves Symptoms and Quality of Life in Diarrhea-Predominant Irritable Bowel Syndrome, Clinical Gastroenterology and Hepatology, AGA Institute, Austin, et. al. Abstract extract:


Participants with moderate to severe IBS-D were provided a 2-week standard diet, then 4 weeks of a VLCD (20 g carbohydrates/d). A responder was defined as having adequate relief of gastrointestinal symptoms for 2 or more weeks during the VLCD. Changes in abdominal pain, stool habits, and quality of life also were measured.

Of the 17 participants enrolled, 13 completed the study and all met the responder definition, with 10 (77%) reporting adequate relief for all 4 VLCD weeks. Stool frequency decreased (2.6 ± 0.8/d to 1.4 ± 0.6/d; P < .001). Stool consistency improved from diarrheal to normal form (Bristol Stool Score, 5.3 ± 0.7 to 3.8 ± 1.2; P < .001). Pain scores and quality-of-life measures significantly improved. Outcomes were independent of weight loss.

A VLCD provides adequate relief, and improves abdominal pain, stool habits, and quality of life in IBS-D.

Chronicling the End of the Low Fat Craze