Low-nickel diet for irritable bowel syndrome

Posted on Mon, 23 Oct 17

Sensitivity to foods high in nickel could cause irritable bowel syndrome, and a new dietary approach has been found to be remarkably successful. 

Based on observations that some patients with irritable bowel syndrome (IBS) have mild intestinal inflammation, and that dietary nickel has been shown to induce inflammation in the gut mucosa of nickel-sensitive patients, a research group from Italy set out to see if a low-nickel diet could help people with IBS [9].

In the study, patients meeting the symptoms-based criteria for IBS were subject to comprehensive medical assessments to rule out other causes of their symptoms.  They then underwent nickel-patch testing to identify nickel sensitivity, with 20 of the 50 initial patients testing positive for nickel sensitivity, 8 non-sensitive, and the remainder excluded for other reasons. Those that tested positive were treated with a low-nickel diet by excluded all foods with a high content of nickel (over 100 μg/kg) for 12-weeks (Table). 

Table: Foods avoided on the low-nickel (Ni) diet

The dietary intervention resulted in a significant improvement of gastrointestinal symptoms, including abdominal bloating, pain/discomfort, flatulence, abdominal cramps, constipation, diarrhea, and nausea. There was also an improvement in intestinal permeability in patients with moderate and strong allergic reactions to nickel at baseline. 

This remarkable study suggests that sensitivity to nickel could be aa very common finding in people presenting with IBS, and that a low-nickel diet can help resolve symptoms. As this is the first study of its kind, these results should stimulate further research as well as the exploratory use of low-nickel diets in clinical practice. 

Reference: 

Rizzi A, Nucera E, Laterza L, et al. Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet? J Neurogastroenterol Motil. 2017 Jan 30;23(1):101-108.