- The American Gastroenterological Association has released guidelines that call for personalized treatments for irritable bowel syndrome (IBS).
- Among other things, the recommendations spell out when to use traditional treatments, new medications, or over-the-counter drugs.
- Experts add that people with IBS can sometimes manage symptoms without drugs with dietary and lifestyle changes.
Researchers have encouraging news for people with irritable bowel syndrome (IBS).
New guidelines from the American Gastroenterological Association specifically spell out when to use traditional therapies, new drugs, or over-the-counter medications to treat IBS.
The new guidelines outline a more personalized approach for treating people with approved drug treatments for IBS with constipation or IBS with diarrhea.
According to the association, IBS is one of the most common disorders of both intestines, affecting up to 35 million people.
It’s distinctly different from inflammatory bowel disease (IBD). While both have similar symptoms, IBS is a gastrointestinal disorder while IBD is considered an autoimmune disease and associated with chronic inflammation, which can result in significant damage to the gastrointestinal tract if left undiagnosed.
The new IBS guidelines are intended to guide doctors in offering a more personalized approach, based on someone’s symptoms.
“We have so many treatment options, we can now take a targeted treatment approach to patient symptoms,” Dr. Shahnaz Sultan, a study author and an associate professor of medicine at the University of Minnesota, said in a statement. “It’s very important for patients to be open about their IBS symptoms and just as important for gastroenterologists to set realistic expectations for this chronic disease to ensure the best quality of life for their IBS patients.”
The association says IBS symptoms can include stomach pain, diarrhea, stomach bloating, constipation, and cramping. Although not life threatening, IBS can be associated with a significant decrease in quality of life, often leaving people self-conscious to participate in everyday activities. IBS affects individuals regardless of race, age, or gender, but it’s most common in women and younger people.
Reaction from an expert
“The new guidelines are not as new as they are more methodical that delineates different treatment options for different variations of IBS,” Dr. Raphael Kellman, a specialist in integrative and functional medicine at the Kellman Wellness Center in New York City, told Healthline.
“However, diet and the use of probiotics and prebiotics are glaringly missing,” Kellman added. “The microbiome diet can significantly help many patients with both forms of IBS.”
Kellman told Healthline there can be more factors when it comes to recommended treatments than the recommendations necessarily spell out.
“There are several underlying factors that are the root cause of IBS, including things like food sensitivities, an imbalanced gut microbiome, or even dysregulation of neurotransmitters,” Kellman noted.
“Many people are familiar with the neurotransmitter, serotonin, as people who suffer from depression often are prescribed SSRIs or selective serotonin reuptake inhibitors, to help boost serotonin levels,” Kellman said. “However, it’s estimated that nearly 95 percent of all the serotonin in the body is found in the digestive tract. It plays a crucial role in the communication between the gut and the brain, as well as the regulation of motility, sensitivity, and secretion of fluids in the gut.”
“Research has shown that people with higher-than-normal levels of serotonin often suffer from diarrhea while people with lower-than-normal levels of serotonin suffer from constipation. Therefore, stress can affect digestion and GI function,” she added.
What you can do
Kashmira Govind, a pharmacist with the Farr Institute, told Healthline that people with IBS can help themselves before seeking treatment.
“The general guidelines for patients are: Lifestyle and dietary modifications should be made before visiting the doctor. Optimize your exercise for your body type and age group, get the necessary sleep. and reduce your stress levels or find ways to manage stress,” Govind said.
“Dietary changes can include increasing fiber intake and following a low-FODMAP diet (FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols). Examples of low FODMAP foods include almond milk, eggs, meat, potatoes, cucumbers, oats, strawberries, oranges, etc,” Govind said.
“Once you decide to see a doctor to manage your condition, be very clear on which symptoms you experience as this will help the doctor decide on the medication is prescribed for you,” Govind recommended.
Kellman said be aware of what food to which you may be allergic.
“Gluten and dairy are the most common offenders,” Kellman said. “Therefore, the symptoms, as well as the underlying root causes must be determined to appropriately treat IBS. Although it is commonly diagnosed, this does not mean that every case should be treated the same way.”
“Sugar, particularly refined carbohydrates, can also contribute to IBS,” she added. “This is primarily because it can cause dysbiosis of the gut microbiome. There are trillions of tiny bacteria living in our GI tract, some are beneficial, while others are pathogenic. The key to gut health is to maintain a good balance of these within the gut.”
“A diet high in sugar and refined carbohydrates is a key factor is why IBS seems to be so prevalent in the United States,” Kellman noted.