Evaluating the Efficacy of the Mediterranean Diet to the Low- Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) Diet in Treating Irritable Bowel Syndrome(IBS)

Inclusion Criteria:

• Patients with IBS-D (diarrhea-predominant IBS) or IBS-M (IBS with mixed subtype)diagnosed per Rome IV questionnaire and without any unexplained alarm features (rectal bleeding, weight loss, nocturnal symptoms, personal history of celiacdisease, microscopic colitis, inflammatory bowel disease)

• Aged 18-70 years at the time of screening

• Weekly average of worst daily (in the past 24 hours) abdominal pain score of ≥3.0 ona 0-to-10-point scale

• At least 80 percent compliance in daily questionnaire entries during the 7-dayscreening period

Exclusion Criteria:

• Subjects adhering to any dietary IBS treatment such as the low-fodmap diet, orgluten-free diet, Mediterranean currently or within the past 6 months

• Subjects with a known food allergy to eggs, seafood, peanuts, tree nuts or milk (subjects with lactose intolerance that are experiencing IBS symptoms while on alactose-free diet will not be excluded from the study).

• Subjects with a history of poorly controlled insulin-dependent ornon-insulin-dependent diabetes

• Subjects with a known history of organic Gastrointestinal (GI) disease (i.e., celiacdisease, inflammatory bowel disease or microscopic colitis)

• Subjects with a history of an eating disorder requiring medical or behavioraltreatment within the past 10 years.

• Subjects with prior small bowel or colonic surgery (excluding appendectomy orcholecystectomy if over 6 months since these 2 procedures)

• Oral antibiotic use in the past 3 months

• Any planned significant changes in dietary or exercise regimen within 30 days priorto Screening or during the study.

• Currently pregnant or breastfeeding.