Irritable bowel syndrome (IBS) is one of the most common and prevalent gastrointestinal disorders that affects a large number of populations worldwide.1 On the world map, it affects 7% to 15% of the general population with mild to severe symptoms. Though there are no reports related to mortality associated with irritable bowel syndrome, it affects the quality of life and work productivity.
There is no cure for IBS, partly because its cause remains unknown. However, there are a number of therapeutic and dietary options available to treat its symptoms. Here, we take a closer look at IBS and the various methods being used to treat it.
IBS is a chronic, functional disorder of the large intestine with symptoms like cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.2 Food movement inside the gastrointestinal tract is highly regulated, and muscle present in the entire tract is responsible for bowel movement. A rapid movement may lead to diarrheal consequences, while on the other hand, a slow movement results in constipation. The muscle movement is called peristaltic movement and is controlled by our brain, mainly the medulla oblongata.
The exact cause of IBS remains unknown, and it is believed the disorder is multifactorial. It may be a result of impaired muscular activity, regulatory events, or both. Clinical observational studies proposed that several factors—including stress, lifestyle, food habits, gut microbiota (bacteria living inside the gastrointestinal tract), genetics and slow inflammation—may be involved in onset and progression of IBS.3
Because it is multifactorial and has a significantly high prevalence, the exact mechanism of IBS remains unexplored. Several mechanisms have been hypothesized to understand the pathogenesis of irritable bowel syndrome, including dysmotility of the gastrointestinal tract, activation of the intestinal mucosa, and visceral hypersensitivity. Additionally, an increased intestinal permeability along with gut microbiota and their interaction with food could be an appropriate reason for IBS.4
Because it is multifactorial and has a significantly high prevalence, the exact mechanism of IBS remains unexplored. Several mechanisms have been hypothesized to understand the pathogenesis of irritable bowel syndrome, including dysmotility of the gastrointestinal tract, activation of the intestinal mucosa, and visceral hypersensitivity. Additionally, an increased intestinal permeability along with gut microbiota and their interaction with food could be an appropriate reason for IBS.4
Apart from these biological factors, environment is centrally associated with IBS. It is evident that interplay between the epithelial barrier and the mucosal immune system are crucial for gut microbiota and inflammatory disorders. The disturbed homeostasis between the epithelial barrier and the mucosal immune system may trigger IBS. Here, environmental factors such as pollution may impart a drastic change in the epithelial barrier and the mucosal immune system balance.5
Diagnosis and treatment of IBS largely rely on symptoms and persistence of symptoms. Abdominal pain, altered bowel habits, and change in stool frequency or forms are key symptoms associated with this condition. In the case of the severe and chronic form of IBS, there will be a significant weight loss, blood/mucus in the stool, fever, and anemia.6
There is no precise medication for IBS. Based on the symptomatic diagnosis, the following treatments are useful in the management of IBS: fiber supplements, peppermint oil, probiotics, anti-cramping therapeutics, medications for constipation or diarrhea, antibiotics, or antidepressants along with psychological treatments.7
As there is no precise medicine and cure for irritable bowel syndrome, alternate therapies seem more relevant. Research studies have demonstrated that stress and food are the key factors associated with IBS. Relief from IBS can be achieved by minimizing stress and opting a recommended diet along with dietary supplements. Using recommended antioxidants may reduce stress levels and could be beneficial in IBS.
Similarly, reducing fried foods, meats, oils, margarine, dairy foods, and other fatty foods will offer relief in IBS. It is recommended to consume more fiber and food items containing high amounts of fiber. Foods such as beans, oatmeal, and some fruits (apples, strawberries, and grapefruit) will be useful in managing IBS.8
Both prebiotics and probiotics are an ideally recommended dietary alternate to maintain a healthy gut microbiome.9 Further, consuming a balanced diet, along with mineral supplements, helps to improve the immune system and reduce inflammation, which is one of the key factors for IBS.
Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAPs) are not clinically recommended for the management of IBS. FODMAPs represent short-chain carbohydrates (SCCs), which are osmotically active, poorly absorbed and rapidly fermented by gut bacteria.10 There is much effort being directed at understanding of the complete mechanism of a low FODMAP diet, and it is believed that such a diet helps in balancing gut microbiota, gut barrier, immune response, and visceral sensation.11
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Rejuvenation Therapeutics
* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
