This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Our purpose is to prospectively determine 1) the effect of a very low carbohydrate diet on quality of life and gastrointestinal symptoms in patients with diarrhea-predominant irritable bowel syndrome (IBS-D); and 2) to determine possible physiological correlates of symptom improvement, as related to post-prandial 5-HT and 5-HIAA release, weight loss and fiber content. These expected findings could lead to a better understanding of the role of diet in IBS and may ultimately help improve patient care.Thirty volunteers will be enrolled at UNC-CH. An index of IBS severity will be used to determine eligibility. All participants will be given two weeks of meals for a carbohydrate-rich diet, followed by four weeks of a very low carbohydrate diet. Outcome measures will include symptoms (standardized abdominal pain, stool form and frequency) using daily diary cards, daily function status, patient quality of life, and post-prandial release of 5-HT and 5-HIAA.
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