Dietary Strategies for Irritable Bowel Syndrome: An Evidence-Based Review of Current and Emerging Interventions

Irritable Bowel Syndrome (IBS) is a chronic, functional gastrointestinal disorder that affects approximately 10–15% of the global population and imposes a significant burden on healthcare systems and patients’ quality of life. Characterized by abdominal pain and altered bowel habits in the absence of structural abnormalities, IBS is now increasingly recognized as a multifactorial condition involving gut-brain axis dysregulation, motility disturbances, visceral hypersensitivity, microbial dysbiosis, and immune activation. Among the most modifiable and impactful contributors to symptom generation is diet. This review explores the evolving understanding of dietary influences on IBS pathophysiology and presents a comprehensive summary of evidence-based nutritional interventions. Traditional and emerging dietary strategies—including low FODMAP, gluten-free, fiber-modulated, and lactose/fructose-restricted diets—are assessed for their clinical efficacy and mechanistic insights. Functional food approaches, such as the use of probiotics, prebiotics, peppermint oil, polyphenols, and low-histamine diets, are also discussed for their therapeutic potential. The review further addresses the integration of personalized nutrition, highlighting the controversial role of food sensitivity testing and the promise of nutrigenomics. It also underscores the importance of combining dietary therapy with lifestyle factors like stress management, physical activity, and cognitive-behavioral support. Clinical guidelines from leading global organizations are reviewed to guide evidence-based practice. In summary, dietary management in IBS is no longer one-size-fits-all but must be individualized, evidence-driven, and holistic. Future research should prioritize long-term outcomes, microbiome-targeted therapies, and precision nutrition.