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Review
. 2025 Jul 30;17(15):2496.
doi: 10.3390/nu17152496.

The Ten Dietary Commandments for Patients with Irritable Bowel Syndrome: A Narrative Review with Pragmatic Indications

Nicola Siragusa  1 , Gloria Baldassari  2 , Lorenzo Ferrario  2 , Laura Passera  2 , Beatrice Rota  3 , Francesco Pavan  1 , Fabrizio Santagata  1 , Mario Capasso  4 , Claudio Londoni  4 , Guido Manfredi  4 , Danilo Consalvo  5 , Giovanni Lasagni  6 , Luca Pozzi  3 , Vincenza Lombardo  3 , Federica Mascaretti  3 , Alice Scricciolo  3 , Leda Roncoroni  3   7 , Luca Elli  3 , Maurizio Vecchi  1   3 , Andrea Costantino  1   3
Affiliations
Review

The Ten Dietary Commandments for Patients with Irritable Bowel Syndrome: A Narrative Review with Pragmatic Indications

Nicola Siragusa et al. Nutrients. .

Abstract

Irritable bowel syndrome (IBS) is a gut-brain axis chronic disorder, characterized by recurrent abdominal pain and altered bowel habits in the absence of organic pathology. Nutrition plays a central role in symptom management, yet no single dietary strategy has demonstrated universal effectiveness. This narrative review critically evaluates current nutritional approaches to IBS. The low-Fermentable Oligo-, Di-, Mono-saccharides and Polyols (FODMAP) diet is the most extensively studied and provides short-term symptom relief, but its long-term effects on microbiota diversity remain concerning. The Mediterranean diet, due to its anti-inflammatory and prebiotic properties, offers a sustainable, microbiota-friendly option; however, it has specific limitations in the context of IBS, particularly due to the adverse effects of certain FODMAP-rich foods. A gluten-free diet may benefit individuals with suspected non-celiac gluten sensitivity, although improvements are often attributed to fructan restriction and placebo and nocebo effects. Lactose-free diets are effective in patients with documented lactose intolerance, while a high-soluble-fiber diet is beneficial for constipation-predominant IBS. IgG-based elimination diets are emerging but remain controversial and require further validation. In this review, we present the 10 dietary commandments for IBS, pragmatic and easily retained recommendations. It advocates a personalized, flexible, and multidisciplinary management approach, avoiding rigidity and standardized protocols, with the aim of optimizing adherence, symptom mitigation, and health-related quality of life. Future research should aim to evaluate, in real-world clinical settings, the impact and applicability of the 10 dietary commandments for IBS in terms of symptom improvement and quality of life.

Keywords: DGBI; diet; irritable bowel syndrome; personalized dietary guidance.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
10 Dietary Commandments for IBS.
See this image and copyright information in PMC

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