Diet, nutraceuticals, and lifestyle interventions for the treatment and management of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is the most common gastrointestinal (GI) disorder of the gut-brain interaction and causes significant GI distress. The etiology of IBS is multifactorial, with food intolerances being a frequent contributing factor to IBS symptoms. Diet and lifestyle interventions are key components in comprehensive IBS care. In this review, we examine the current evidence-based dietary approaches for treating IBS. The low-FODMAP diet has the most robust data for improving overall symptom burden. In conjunction with guidance from a registered dietitian, certain patients may benefit from targeted dietary elimination of specific carbohydrates such as lactose or fructose or gluten. Among the nutraceuticals used to treat IBS, peppermint oil has sufficient evidence and appropriate safety data to recommend adjunctive use to reduce IBS symptoms. Although prebiotic and probiotic food sources may be beneficial to the microbiome, there is not enough evidence to support the routine use of prebiotic or probiotic supplements. Given the complexity of IBS, a holistic approach in which clinicians address a patients' diet, culture, sleep hygiene, exercise habits, and mental health may improve patients' overall quality of life.