J Neurogastroenterol Motil 2019; 25(2): 222-232  
Self-reported Food Intolerance in Korean Patients With Irritable Bowel Syndrome
Hyo Jeong Lee,1 Hyun Jin Kim,2 Eun Hee Kang,1 Kee Wook Jung,3 Seung-Jae Myung,3 Yang Won Min,4 Chang Hwan Choi,5, Han Seung Ryu,6 Jong Kyoung Choi,7 Joong Goo Kwon,8 Kyoung Sup Hong,9,10* and Kyung Sik Park11*
1Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 2Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea; 3Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 4Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 5Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea; 6Department of Internal Medicine, Wonkwang University College of Medicine and Digestive Disease Research Institute, Iksan, Jeollabuk-do, Korea; 7Department of Internal Medicine, National Medical Center, Seoul, Korea; 8Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea; 9Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea; 10Department of Gastroenterology, Mediplex Sejong Hospital, Incheon, Korea (Current address); and 11Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
Correspondence to: *Kyoung Sup Hong, MD, PhD
Department of Gastroenterology, Mediplex Sejong Hospital, 20 Gyeyangmunhwa-ro, Gyeyang-gu, Incheon 21080, Korea, Tel: +82-32-240-8547, Fax: +82-32-240-8094, E-mail: kshong1@empas.com
Kyung Sik Park, MD, PhD
Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea, Tel: +82-53-250-7088; Fax: +82-53-250-7442; E-mail: seenae99@dsmc.or.kr
Sup Hong and Kyung Sik Park are equally responsible for this work.
Received: July 20, 2018; Revised: November 8, 2018; Accepted: November 27, 2018; Published online: April 30, 2019.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Various foods trigger and/or worsen the symptoms of irritable bowel syndrome (IBS). However, Korean food-related gastrointestinal (GI) symptoms in IBS patients have not yet been investigated. This study aims to evaluate the prevalence of self-reported food intolerance in Korean IBS patients and determine the Korean food items and food groups perceived by patients to worsen their GI symptoms.
Methods: We recruited 393 study subjects, comprising 101 IBS patients, 167 symptomatic non-IBS subjects, and 125 control subjects. All participants completed a questionnaire to identify the most problematic foods and assess the occurrence of GI symptoms caused by 119 Korean food items. They also completed the validated Rome III questionnaire for IBS.
Results: The prevalence of self-reported food intolerance in Korean IBS patients was 79.2%, which was significantly higher than that in control subjects (44.8%, P < 0.001). The most problematic foods reported by IBS patients who experienced food intolerance were high-fat foods (25.0%), gluten foods (23.8%), spicy foods (15.0%), and dairy products (15.0%). A total of 63.4% of IBS patients reported GI symptoms related to the consumption of foods high in fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP), while 48.5% of IBS patients reported symptoms associated with high-fat foods. Gas problems and loose stools were the most frequently reported symptoms.
Conclusions: A large proportion of Korean IBS patients complained of intolerance to certain food items, with high-fat and high-FODMAP foods being the main triggers. This study provides a basis for planning food intervention studies for Korean IBS patients.
Keywords: Diet; Food intolerance; Irritable bowel syndrome; Surveys and questionnaires

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