Medically reviewed by Onikepe Adegbola, MD, PhD
Irritable bowel syndrome (IBS) is a long-term condition that causes stomach pain. Clinical criteria are utilized to diagnose it, although in some cases, biochemical and imaging studies are used to aid in the diagnosis. Irritable bowel syndrome can be treated with a variety of approaches, including lifestyle changes, non-pharmaceutical treatments, and traditional medications. Non-pharmaceutical treatments include dietary changes, probiotics, and fiber.
IBS-D is a subtype of irritable bowel syndrome that causes diarrhea, whereas IBS-C is a subtype of irritable bowel syndrome that causes constipation.
New Findings, New Scope
“Diet, fibers, and probiotics for Irritable Bowel Syndrome” in the Journal of Medicine and Life focuses on dietary interventions, probiotics, and fibers that are non-pharmaceutical treatments for IBS.
The new Rome IV criteria, which were utilized in the most recent global study on functional gastrointestinal disorders, are more restricted in identifying IBS, and it is more common in women and those under 50. IBS treatment is difficult, with non-pharmacological alternatives being recommended first.
Food plays a dual role in IBS: it can both induce symptoms and be used to treat them. A low-FODMAP (LFD), mNICE-modified diet, and adequate water are all beneficial.
FODMAP
FODMAPs are short-chain fermentable carbohydrates found in stone fruits, cereals, vegetables, milk-derived products, and artificial sweeteners that interact with the gut microbiota to create bloating and colonic distention, which are both symptoms of IBS.
FODMAPs affect IBS symptoms in 70% of patients, according to two studies, and there is no difference in response between LFD and typical dietary guidance.
Gut dysmotility, visceral hypersensitivity, and aberrant secretion are all symptoms of IBS patients’ guts having a lower density of endocrine cells. Although a low FODMAP diet was effective in treating IBS symptoms, it had medical and personal drawbacks. LFD had limitations such as malnutrition risk and effects on the gut microbiota. Moreover, it is expensive to follow this diet.
Gluten-Free Diet
Gluten sensitivity and lactose intolerance are two conditions that affect a large percentage of the population. A gluten-free diet has not been shown to have a substantial effect on IBS patients in studies, and various groups do not recommend a gluten-free diet for IBS patients.
mNICE
Another alternative for IBS patients is the mNICE diet, which suggests avoiding trigger foods, avoiding alcohol and caffeine, and using psyllium husk as a fiber source. It shows the same effect as LFD in some patients, without the disadvantages.
Fiber
Fibers are well-known for their ability to treat gastrointestinal issues. However, the type of fiber, daily intake, and IBS subtype must all be taken into account.
Insoluble fibers (corn, wheat bran, linseeds) provide little value in the treatment of IBS symptoms and, in some situations, even have the opposite effect. The best success in reducing IBS symptoms comes from soluble viscous low fermentable fibers (psyllium, ispaghula). They can help treat bloating, flatulence, abdominal distention, and increased fecal weight. The benefits of psyllium in patients with IBS-C and IBS-D have been shown, but the data are insufficient to suggest the best dose and duration of the treatment.
Probiotics
Probiotics are living bacteria and yeasts that, when taken, can improve a patient’s health, particularly in the digestive tract. The gut microbiota of IBS sufferers differs from that of healthy people, making it possible to regulate intestinal microbes to alleviate IBS symptoms. Prebiotics are fibers that nourish the healthy bacteria in the gut.
Although studies on gut microbiota manipulation have yielded promising outcomes, there is a paucity of solid data on which bacteria are helpful and how they affect IBS. However, probiotics are often recommended for IBS.
In individuals with IBS D and IBS C, probiotics can enhance stool frequency and consistency, reduce stomach aches, bloating, and flatulence, modify gastrointestinal motility, and diminish visceral hypersensibility.
The results of a review suggest that treatment with low or high doses of probiotics improves IBS symptoms and improves the quality of life (QoL). For IBS patients, the most beneficial bacteria are S. cerevisiae, Bifidobacterium infantis, and Lactobacillus plantarum.
It has been found that probiotics can reduce abdominal pain, bloating, and flatulence in patients with IBS D and IBS C. Probiotics can restore intestinal microbiota dysbiosis, and modulate GI motility. They also reduce visceral hyper sensibility and reduce mucosal immune responses.
Treatment options for IBS include dietary interventions, fibers, and probiotics. More research is needed to determine their efficacy and safety.
Summary
IBS is a condition that causes intestinal problems. The symptoms of IBS include stomach pain and changes in bowel habits. Doctors may prescribe pharmaceutical or non-pharmaceutical treatment. From lifestyle changes to medicines, you may have to try a few treatments to see what works best for you. Fiber intake is the key to effectiveness against IBS.
Different fibers take part in fermentation processes in the colon. Soluble viscous low fermentable fibers (psyllium, ispaghula) are the most effective. For IBS patients, the most beneficial bacteria are S. cerevisiae, Bifidobacterium infantis, and Lactobacillus plantarum.
Reference:
Galica, A. N., Galica, R., & Dumitrașcu, D. L. (2022). Diet, fibers, and probiotics for irritable bowel syndrome. Journal of medicine and life, 15(2), 174–179. https://doi.org/10.25122/jml-2022-0028
