Individualized targeted exclusion diet based on confocal laser endomicroscopy does not improve irritable bowel syndrome symptoms: a randomized controlled crossover trial

The authors aimed to determine whether a targeted exclusion diet, based on food-induced mucosal alterations visualized through confocal laser endomicroscopy (CLE), could improve symptoms in patients with irritable bowel syndrome (IBS). In a randomized controlled crossover trial, they found no significant difference in clinical response rates between the real diet and a sham diet, suggesting that the mucosal changes observed may not be specific indicators of dietary triggers in IBS. The study challenges the clinical utility of CLE for identifying foods that exacerbate IBS symptoms.