Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102079
Stine Störsrud, Joost P. Algera, Hans Törnblom
Functional dyspepsia (FD) and gastroparesis (GP) are chronic upper gastrointestinal disorders in which symptoms are closely linked to food intake. However, dietary interventions remain insufficiently studied, and the clinical overlap between the two conditions poses challenges for study design and interpretation. This review summarizes current evidence on the impact of eating behaviors, specific diets and food items, and macronutrient composition on symptom generation in FD and GP, and considers how these findings may inform nutritional management strategies. While emerging data suggest potential dietary approaches, evidence-based recommendations remain limited. Well-designed randomized controlled trials with standardized diagnostic criteria, validated outcome measures, and integration of physiological biomarkers are urgently needed to establish effective, individualized dietary interventions for these disorders.
{"title":"Nutritional management in functional dyspepsia and gastroparesis","authors":"Stine Störsrud, Joost P. Algera, Hans Törnblom","doi":"10.1016/j.bpg.2025.102079","DOIUrl":"10.1016/j.bpg.2025.102079","url":null,"abstract":"<div><div>Functional dyspepsia (FD) and gastroparesis (GP) are chronic upper gastrointestinal disorders in which symptoms are closely linked to food intake. However, dietary interventions remain insufficiently studied, and the clinical overlap between the two conditions poses challenges for study design and interpretation. This review summarizes current evidence on the impact of eating behaviors, specific diets and food items, and macronutrient composition on symptom generation in FD and GP, and considers how these findings may inform nutritional management strategies. While emerging data suggest potential dietary approaches, evidence-based recommendations remain limited. Well-designed randomized controlled trials with standardized diagnostic criteria, validated outcome measures, and integration of physiological biomarkers are urgently needed to establish effective, individualized dietary interventions for these disorders.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102079"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102075
E. Scarpellini , W. Siquini
Background
Dumping syndrome is defined by the occurrence of ‘dumping-like’ symptoms after surgery of the upper GI tract, triggered by food reaching the small bowel too rapidly or in too high quantity. There are two different subsets of symptoms and signs, classified as early and late dumping, respectively. Nutritional approach is recommended with different levels of evidence across the managing flow-chart of the syndrome.
Methods
We performed a narrative review of literature evidence on the nutritional approach to dumping syndrome. In detail, we made a search on main medical databases for publications using the following keywords, their acronyms and their associations (e.g., “and “): “Dumping syndrome”,” Treatment”, “Nutrition”, “Dietary supplements”, “Food viscosity”, “Artificial Nutrition”.
Results
Dietary adjustment remains the initial step in the management of dumping syndrome and can be maintained throughout the patients' natural history. In detail, in patients with late dumping, rapidly absorbable carbohydrates and lactose must be avoided. In case of insufficient response to diet alone, dietary supplements increasing food viscosity have successfully been used. Similarly, corn starch has shown efficacy for children suffering from dumping symptoms. Increased amount of dietary soluble fibers increases intestinal transit time, delays glucose absorption, and improves patients’ symptoms. In refractory patients, continuous enteral nutrition via a nasogastric tube or a feeding jejunostomy has been used, especially for late dumping hypoglycemia.
Conclusions
some data from literature supports the use of nutritional schemes and agents enhancing food viscosity for dumping symptoms management. In refractory cases, enteral nutrition can be attempted. Larger RCTs are needed to confirm these observations.
{"title":"Nutritional approach to dumping syndrome","authors":"E. Scarpellini , W. Siquini","doi":"10.1016/j.bpg.2025.102075","DOIUrl":"10.1016/j.bpg.2025.102075","url":null,"abstract":"<div><h3>Background</h3><div>Dumping syndrome is defined by the occurrence of ‘dumping-like’ symptoms after surgery of the upper GI tract, triggered by food reaching the small bowel too rapidly or in too high quantity. There are two different subsets of symptoms and signs, classified as early and late dumping, respectively. Nutritional approach is recommended with different levels of evidence across the managing flow-chart of the syndrome.</div></div><div><h3>Methods</h3><div>We performed a narrative review of literature evidence on the nutritional approach to dumping syndrome. In detail, we made a search on main medical databases for publications using the following keywords, their acronyms and their associations (e.g., “and “): “Dumping syndrome”,” Treatment”, “Nutrition”, “Dietary supplements”, “Food viscosity”, “Artificial Nutrition”.</div></div><div><h3>Results</h3><div>Dietary adjustment remains the initial step in the management of dumping syndrome and can be maintained throughout the patients' natural history. In detail, in patients with late dumping, rapidly absorbable carbohydrates and lactose must be avoided. In case of insufficient response to diet alone, dietary supplements increasing food viscosity have successfully been used. Similarly, corn starch has shown efficacy for children suffering from dumping symptoms. Increased amount of dietary soluble fibers increases intestinal transit time, delays glucose absorption, and improves patients’ symptoms. In refractory patients, continuous enteral nutrition via a nasogastric tube or a feeding jejunostomy has been used, especially for late dumping hypoglycemia.</div></div><div><h3>Conclusions</h3><div>some data from literature supports the use of nutritional schemes and agents enhancing food viscosity for dumping symptoms management. In refractory cases, enteral nutrition can be attempted. Larger RCTs are needed to confirm these observations.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102075"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102077
Karen Van den Houte
Functional bowel disorders, classified as disorders of gut-brain interaction, are highly prevalent and characterized by chronic gastrointestinal symptoms in the absence of identifiable structural abnormalities. The pathophysiology of these disorders is multifactorial. Given this complexity, a symptom-directed treatment approach is essential. As the majority of these patients report food-related symptoms, first-line therapy typically involves the implementation of general dietary and lifestyle advice, as recommended by the British Dietetic Association's (BDA) evidence-based guidelines and U.K's National Institute of Health and Care Excellence (NICE) guidelines. For patients not achieving adequate symptom relief with general guidance, second-line interventions may include targeted exclusion diets, eliminating carbohydrates or proteins. This review focuses on the dietary approaches used in patients with functional bowel disorders, particularly in irritable bowel syndrome (IBS), the most studied disorder. Special attention is given to the low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet is well studied, including its rationale, pathophysiology, effect on gastrointestinal symptoms, and limitations of the diet. Additional dietary strategies are explored, including the starch and sucrose reduced diet, the gluten-free diet or a diet focusing on dietary proteins. Overall, this review synthesizes the current evidence supporting dietary therapies in functional bowel disorders and highlights the need for personalized, multidisciplinary approaches to optimize patient outcomes.
{"title":"Dietary approaches in functional bowel disorders","authors":"Karen Van den Houte","doi":"10.1016/j.bpg.2025.102077","DOIUrl":"10.1016/j.bpg.2025.102077","url":null,"abstract":"<div><div>Functional bowel disorders, classified as disorders of gut-brain interaction, are highly prevalent and characterized by chronic gastrointestinal symptoms in the absence of identifiable structural abnormalities. The pathophysiology of these disorders is multifactorial. Given this complexity, a symptom-directed treatment approach is essential<strong>.</strong> As the majority of these patients report food-related symptoms, first-line therapy typically involves the implementation of general dietary and lifestyle advice, as recommended by the British Dietetic Association's (BDA) evidence-based guidelines and U.K's National Institute of Health and Care Excellence (NICE) guidelines. For patients not achieving adequate symptom relief with general guidance, second-line interventions may include targeted exclusion diets, eliminating carbohydrates or proteins. This review focuses on the dietary approaches used in patients with functional bowel disorders, particularly in irritable bowel syndrome (IBS), the most studied disorder. Special attention is given to the low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet is well studied, including its rationale, pathophysiology, effect on gastrointestinal symptoms, and limitations of the diet. Additional dietary strategies are explored, including the starch and sucrose reduced diet, the gluten-free diet or a diet focusing on dietary proteins. Overall, this review synthesizes the current evidence supporting dietary therapies in functional bowel disorders and highlights the need for personalized, multidisciplinary approaches to optimize patient outcomes.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102077"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102081
Maxim D'heedene , Jason A. Tye-Din , Lucas Wauters
Coeliac disease is an immune-mediated enteropathy triggered by gluten ingestion. While a strict gluten-free diet remains the basis of treatment, a sizeable proportion of patients continue to experience symptoms or histological abnormalities despite adherence. This clinical entity of non-responsive coeliac disease imposes diagnostic and therapeutic challenges. Inadvertent gluten intake is a leading cause and can be difficult to detect, but measuring gluten immunogenic peptides in the urine or stool can provide objective evidence of exposure. Persistent symptoms or enteropathy can also originate from coexisting gastrointestinal disorders or the rare complication of refractory coeliac disease, which requires specialized treatment. Several novel therapies, including intestinal gluten neutralization, intestinal permeability modulation, HLA-gluten or cytokine blockade, transglutaminase inhibition and induction of gluten tolerance have reached Phase 1b/2 clinical trials. While coeliac drug development still faces several hurdles, these advances offer hope for more personalized, effective management beyond the gluten-free diet.
{"title":"Persistent symptoms and enteropathy in coeliac disease: clinical considerations and therapeutic opportunities","authors":"Maxim D'heedene , Jason A. Tye-Din , Lucas Wauters","doi":"10.1016/j.bpg.2025.102081","DOIUrl":"10.1016/j.bpg.2025.102081","url":null,"abstract":"<div><div>Coeliac disease is an immune-mediated enteropathy triggered by gluten ingestion. While a strict gluten-free diet remains the basis of treatment, a sizeable proportion of patients continue to experience symptoms or histological abnormalities despite adherence. This clinical entity of non-responsive coeliac disease imposes diagnostic and therapeutic challenges. Inadvertent gluten intake is a leading cause and can be difficult to detect, but measuring gluten immunogenic peptides in the urine or stool can provide objective evidence of exposure. Persistent symptoms or enteropathy can also originate from coexisting gastrointestinal disorders or the rare complication of refractory coeliac disease, which requires specialized treatment. Several novel therapies, including intestinal gluten neutralization, intestinal permeability modulation, HLA-gluten or cytokine blockade, transglutaminase inhibition and induction of gluten tolerance have reached Phase 1b/2 clinical trials. While coeliac drug development still faces several hurdles, these advances offer hope for more personalized, effective management beyond the gluten-free diet.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102081"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102080
Christian von Muhlenbrock , Federico Aronsohn , Rodrigo Quera , Ana María Madrid
Dietary fiber (DF) used to be seen merely as an indigestible component, but it is now recognized as essential for both gut and overall metabolic health. Historically, humans consumed between 70 and 120 g of fiber per day, far more than the less than 20 g typically eaten today, despite WHO recommendations of 25–35 g daily. The physiological effects of dietary fibers depend on a complex interplay of their physicochemical properties (solubility, viscosity, and fermentability) rather than on a single characteristic. These properties determine how fibers interact with different segments of the gastrointestinal tract, influencing motility, fermentation, and barrier function. This review examines how distinct types and combinations of dietary fibers modulate gastrointestinal physiology and symptoms in various disorders, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease. For example, fibers such as psyllium, which combine solubility with moderate viscosity and fermentability, can improve bowel habits and reduce symptom burden in IBS, though responses vary among individuals. In IBD, high-fiber diets, particularly Mediterranean-style ones, appear safe and may even confer protection. Similarly, fiber from fruits and cereals is associated with a reduced risk of diverticular disease. Overall, understanding how multiple fiber properties interact to influence gastrointestinal function may allow more targeted dietary recommendations according to specific clinical contexts. Further research is needed to define the optimal types and amounts of fiber for different conditions and individuals.
{"title":"The role of dietary fiber in the gastrointestinal tract: when, how and why?","authors":"Christian von Muhlenbrock , Federico Aronsohn , Rodrigo Quera , Ana María Madrid","doi":"10.1016/j.bpg.2025.102080","DOIUrl":"10.1016/j.bpg.2025.102080","url":null,"abstract":"<div><div>Dietary fiber (DF) used to be seen merely as an indigestible component, but it is now recognized as essential for both gut and overall metabolic health. Historically, humans consumed between 70 and 120 g of fiber per day, far more than the less than 20 g typically eaten today, despite WHO recommendations of 25–35 g daily. The physiological effects of dietary fibers depend on a complex interplay of their physicochemical properties (solubility, viscosity, and fermentability) rather than on a single characteristic. These properties determine how fibers interact with different segments of the gastrointestinal tract, influencing motility, fermentation, and barrier function. This review examines how distinct types and combinations of dietary fibers modulate gastrointestinal physiology and symptoms in various disorders, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and diverticular disease. For example, fibers such as psyllium, which combine solubility with moderate viscosity and fermentability, can improve bowel habits and reduce symptom burden in IBS, though responses vary among individuals. In IBD, high-fiber diets, particularly Mediterranean-style ones, appear safe and may even confer protection. Similarly, fiber from fruits and cereals is associated with a reduced risk of diverticular disease. Overall, understanding how multiple fiber properties interact to influence gastrointestinal function may allow more targeted dietary recommendations according to specific clinical contexts. Further research is needed to define the optimal types and amounts of fiber for different conditions and individuals.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102080"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102073
Anne Godat , Thomas Greuter
Eosinophilic esophagitis (EoE) is a chronic, food-mediated type 2 (T2) inflammatory disease of the esophagus. Elimination of dietary triggers, particularly cow's milk, results in considerable rates of both histological and clinical disease remission. A growing body of evidence supports the role of food allergens in initiating and maintaining esophageal inflammation, either through direct disruption of the epithelial barrier or via interaction with antigen-presenting cells in the subepithelial tissue. Importantly, EoE is not a classical IgE-mediated food allergy, and conventional allergy tests have a poor predictive value in guiding dietary interventions. While IgG4 antibodies have been implicated in the disease process, their role remains unclear and may reflect a bystander phenomenon rather than a causal mechanism. Recently, a novel food-induced immediate reaction of the esophagus (FIRE) has been described in EoE patients. This reaction involves rapid onset esophageal symptoms following ingestion of specific food allergens and bears resemblance to the oral allergy syndrome. Finally, a direct effect of food allergens has been shown in experimental procedures using injection of allergens into the esophageal mucosa and in vitro by stimulating freshly collected esophageal biopsies. The following review summarizes the up-to-date knowledge about food reactions in EoE.
{"title":"Food-related reactions in eosinophilic esophagitis: pathophysiology and treatment","authors":"Anne Godat , Thomas Greuter","doi":"10.1016/j.bpg.2025.102073","DOIUrl":"10.1016/j.bpg.2025.102073","url":null,"abstract":"<div><div>Eosinophilic esophagitis (EoE) is a chronic, food-mediated type 2 (T2) inflammatory disease of the esophagus. Elimination of dietary triggers, particularly cow's milk, results in considerable rates of both histological and clinical disease remission. A growing body of evidence supports the role of food allergens in initiating and maintaining esophageal inflammation, either through direct disruption of the epithelial barrier or via interaction with antigen-presenting cells in the subepithelial tissue. Importantly, EoE is not a classical IgE-mediated food allergy, and conventional allergy tests have a poor predictive value in guiding dietary interventions. While IgG4 antibodies have been implicated in the disease process, their role remains unclear and may reflect a bystander phenomenon rather than a causal mechanism. Recently, a novel food-induced immediate reaction of the esophagus (FIRE) has been described in EoE patients. This reaction involves rapid onset esophageal symptoms following ingestion of specific food allergens and bears resemblance to the oral allergy syndrome. Finally, a direct effect of food allergens has been shown in experimental procedures using injection of allergens into the esophageal mucosa and in vitro by stimulating freshly collected esophageal biopsies. The following review summarizes the up-to-date knowledge about food reactions in EoE.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102073"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102086
Jessica R. Biesiekierski
Gluten-free diets (GFDs) are widely adopted for gastrointestinal complaints, yet evidence from well-controlled gluten challenge studies supporting gluten-specific symptom generation outside coeliac disease is inconsistent. Across trials, reproducible gluten-specific effects largely disappear once fermentable carbohydrates (FODMAPs) and expectation biases are controlled for, and meta-analyses report only modest, inconsistent symptom relief. Large nocebo responses and methodological heterogeneity undermine confidence in the construct of “non-coeliac gluten sensitivity”. Re-interpreting gluten-attributed symptoms through the paradigm of disorders of gut–brain interaction provides a clinically coherent framework that integrates visceral hypersensitivity, cognitive-affective processes and sociocultural drivers. This review synthesises mechanistic and clinical data, distils methodological lessons and offers practical guidance on when, and how, to consider gluten restriction. A GFD should be a last resort, time-limited probe, supervised by a dietitian, and embedded within multidisciplinary care focused on individual symptom mechanisms.
{"title":"Clinical utility of gluten restriction in gastrointestinal disorders: Evidence, practice, and reappraisal of non-coeliac gluten sensitivity","authors":"Jessica R. Biesiekierski","doi":"10.1016/j.bpg.2025.102086","DOIUrl":"10.1016/j.bpg.2025.102086","url":null,"abstract":"<div><div>Gluten-free diets (GFDs) are widely adopted for gastrointestinal complaints, yet evidence from well-controlled gluten challenge studies supporting gluten-specific symptom generation outside coeliac disease is inconsistent. Across trials, reproducible gluten-specific effects largely disappear once fermentable carbohydrates (FODMAPs) and expectation biases are controlled for, and meta-analyses report only modest, inconsistent symptom relief. Large nocebo responses and methodological heterogeneity undermine confidence in the construct of “non-coeliac gluten sensitivity”. Re-interpreting gluten-attributed symptoms through the paradigm of disorders of gut–brain interaction provides a clinically coherent framework that integrates visceral hypersensitivity, cognitive-affective processes and sociocultural drivers. This review synthesises mechanistic and clinical data, distils methodological lessons and offers practical guidance on when, and how, to consider gluten restriction. A GFD should be a last resort, time-limited probe, supervised by a dietitian, and embedded within multidisciplinary care focused on individual symptom mechanisms.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102086"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.bpg.2025.102076
Karen Routhiaux , Tom van Gils , Lukas Michaja Balsiger
Disorders of gut brain interaction (DGBI) is an umbrella term for a group of prevalent symptomatic gastrointestinal disorders. Although typically not associated with increased mortality, these disorders have a major impact on patients’ quality of life and have an economic impact on an individual and societal level. Many patients suffering from DGBI relate symptom onset or increase to food intake making dietary interventions an appealing treatment strategy. Typically, dietary interventions consist of excluding (presumed) culprit foods from the diet of patients. Many efforts are ongoing to prospectively identify culprit nutrients and enable tailored individualized dietary interventions. Here, we summarize the evidence for candidate biomarkers being studied for this purpose. We comment on the established empirical dietary interventions and highlight the important role of expert dieticians in administering these diets. We finally describe, which patients are likely to benefit from empirical dietary interventions and in which patients restrictive dietary interventions should be avoided.
{"title":"Targeted and individualized dietary interventions in disorders of gut-brain interaction","authors":"Karen Routhiaux , Tom van Gils , Lukas Michaja Balsiger","doi":"10.1016/j.bpg.2025.102076","DOIUrl":"10.1016/j.bpg.2025.102076","url":null,"abstract":"<div><div>Disorders of gut brain interaction (DGBI) is an umbrella term for a group of prevalent symptomatic gastrointestinal disorders. Although typically not associated with increased mortality, these disorders have a major impact on patients’ quality of life and have an economic impact on an individual and societal level. Many patients suffering from DGBI relate symptom onset or increase to food intake making dietary interventions an appealing treatment strategy. Typically, dietary interventions consist of excluding (presumed) culprit foods from the diet of patients. Many efforts are ongoing to prospectively identify culprit nutrients and enable tailored individualized dietary interventions. Here, we summarize the evidence for candidate biomarkers being studied for this purpose. We comment on the established empirical dietary interventions and highlight the important role of expert dieticians in administering these diets. We finally describe, which patients are likely to benefit from empirical dietary interventions and in which patients restrictive dietary interventions should be avoided.</div></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":"79 ","pages":"Article 102076"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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