SAN ANTONIO — Zinc deficiency may perpetuate the underlying pathophysiology of irritable bowel syndrome (IBS) as well as associated psychiatric conditions, via the role zinc plays in the “brain-gut” axis, the immune system, and gastrointestinal barrier integrity, according to research presented at the ACG Annual Scientific Meeting, held October 25 to 30, 2019, in San Antonio, Texas.

IBS affects 12% of the population, but the quality of evidence supporting current interventions has been rated very low; most patients with IBS report unchanged or worsened symptoms over time. This cross-sectional analysis was designed to compare serologic markers of nutritional status and dietary composition in individuals with and without IBS to identify potential targets for supplementation therapy. All 17 national surveys conducted in the United States between 1959 and 2019 were screened for eligibility, but only one, the Second National Health and Nutrition Examination Survey (NHANES II) (1976-1980), provided comprehensive IBS data. Investigators performed a cross-sectional analysis of data on 12,295 adults age 18 to 74 years, with IBS diagnosis based on self-reporting.

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Individuals with IBS had significantly higher ratios of copper to zinc (1.70 vs 1.55, P =.048) and were more likely to have ratios >1.8 (OR, 1.79; 95% CI, 1.02-3.13), which suggests an underlying zinc deficiency. Because the largest source of dietary zinc in the study population was milk, this deficiency may be the result of these individuals’ avoidance of dairy. While responders with IBS were significantly more likely to report dietary avoidances, they did not show serologic evidence of any other nutritional deficiencies. Furthermore, dietary recall showed that macro and micronutrient intake did not significantly differ between groups, and individuals with IBS were more likely to take vitamin supplements as compared with individuals without IBS (P =.003).

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Study investigators concluded, “Zinc deficiency may perpetuate the underlying pathophysiology of IBS and may contribute to the associated psychiatric conditions through zinc’s role in the immune system, ‘brain-gut’ axis, and gastrointestinal barrier integrity. This suggests that zinc supplementation may be a potential therapy both to mitigate underlying pathology as well as improve symptoms. Our findings should be confirmed in future studies, and the association of copper-zinc ratios with symptom severity, and the response of symptoms to supplementation could be investigated.”


Hujoel IA. Nutritional deficiencies in irritable bowel syndrome: A north American population-based study. Presented at: ACG Annual Scientific Meeting; October 25-30, 2019; San Antonio, TX. Abstract # P0339