Lethargy
Lethargy is a chronic state of weariness, diminished energy, reduced mental capacity, and a lack of motivation. Lethargy may be caused by a lack of sleep, physical exertion, or underlying disease.
Last Updated:October 13, 2024
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In this meta-analysis, there was low-quality to very-low-quality evidence that gluten-free diets (compared to gluten-containing diets) improved abdominal pain, but not other gastrointestinal symptoms, and they were less effective than low-FODMAP diets for IBS symptoms and quality of life.
What was studied?
Whether a gluten-free diet improves gastrointestinal symptoms and quality of life in adults with irritable bowel syndrome (IBS) when compared to gluten-containing and low-FODMAP diets.
The main outcomes were GI symptoms, including abdominal pain, bloating, nausea, tiredness, satisfaction with stool consistency, and quality of life.
Who was studied?
Adults and adolescents (ages 16 and older) with IBS (excluding celiac disease) diagnosed using the Rome III/IV criteria.
How was it studied?
A meta-analysis of 9 studies including 8 randomized controlled trials and 1 nonrandomized study was performed.
The included studies were conducted in Iran (4 studies), Sweden (2 studies), and Italy, the United Kingdom, and India (1 study each).
The interventions included gluten-free or gluten-restricted diets, and the comparator groups included placebo, a low-FODMAP diet, a regular diet, or any non-gluten-restricted diet. The intervention duration ranged from 1 to 12 weeks. The diets contained zero gluten or — for gluten-containing interventions — the dosage of gluten was 5 to 32 grams per day.
Subgroup analyses were performed to determine whether the study duration (4 weeks or more vs. less than 4 weeks), gluten dose (elimination vs. restriction), or IBS subtype (constipation, diarrhea, or mixed) influenced the results.
What were the results?
Gluten-free diets reduced abdominal pain compared to gluten-containing diets. Also, overall symptoms improved in studies that were 4 weeks or longer, but not in those lasting less than 4 weeks.
Low-FODMAP diets improved IBS symptom severity scores and quality of life compared to gluten-free diets.
Anything else I need to know?
The quality of the evidence for the comparison of gluten-free diets and gluten-containing diets was rated as “very low”, whereas the evidence quality for gluten-free diets vs. low-FODMAP diets was rated as “low.” This reduces the confidence in the findings of this meta-analysis and indicates the need for more research in this area.