No study has been conducted to investigate the association between dietary acid load and irritable bowel syndrome (IBS). So, this cross-sectional study was performed to investigate the association between dietary acid load and odds of IBS, its severity, and IBS subtypes. A sample of 3362 Iranian subjects was selected from health centers in Isfahan province. A validated semi-quantitative food frequency questionnaire (DS-FFQ) was applied to estimate dietary intakes. The dietary acid load was measured using net endogenous acid production (NEAP), dietary acid load (DAL), and potential renal acid load (PRAL) scores. In crude models, the highest compared with the lowest category of the PRAL score was significantly associated with increased odds of IBS severity in participants with BMI ≥ 25 (kg/m2) (OR = 1.54; 95% CI = (1.03-2.32). Also, the results indicated a significant positive association between the PARL and odds of mixed subtype of IBS (OR = 1.74; 95% CI = (1.11-2.74); P trend = 0.02). In propensity score-adjusted model with potential confounders, only a positive association was found between PRAL and odds of mixed subtype of IBS (OR = 1.78; 95% CI = (1.05-3.00); P trend = 0.03). The DAL and NEAP scores tended to show non-significant similar findings. This study indicates that dietary acid load might be associated with odds of mixed type of IBS. However, further research is warranted to infer these findings.
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