5 IBS treatment options
If you have received a diagnosis of irritable bowel syndrome (IBS) and want to consider natural IBS treatment options here are 5 of the most cutting edge:
IBS treatment option 1 – Dietary exclusion
Cut down fermentable carbohydrates, these are found in in vegetables, milk, breads, cereals, pasta, legumes and certain fruits, such as apples, pears, nectarines, peaches, plums, apricots and cherries (livestrong). This is the basis for the FODMAP diet, which has been demonstrated to produce good results (Ross et al 2016, Schumann et al 2019) comparable to counselling (Jankovich & Watkins 2016). However the need to consult a specially trained FODMAP Dietician is stressed, and it appears to work best for IBS-D. (Schumann et al 2019)
IBS treatment option 2 – Probiotics
Toping up with a bit of healthy gut bacteria is beneficial for many people. A recent review of studies published by the British Dietetic Association found that 59% of randomised control trials (RTC’s) for the use of probiotic treatment showed some benefit, either to symptoms or quality of life. This also means that 41% showed no benefit and they were unable to identify a particular strain which proved more beneficial than any other. The pattern of some effect but generally lower than most interventions was confirmed by a review of 37 clinical research trials. (Ford.a et al 2018) However, it clearly can be beneficial and a short course of probiotic therapy is very cheap so it’s probably more than worth it. (Mckenzie et al 2016)
IBS treatment option 3 – Acupuncture
A much anticipated follow up by MacPherson et al back in 2016 found no significant difference between the treatment as usual group and the acupuncture groups. This doesn’t mean that acupuncture doesn’t work for IBS it simply doesn’t appear to be any better than the normal treatments, a fact confirmed by an analysis of 27 randomised controlled trials of acupuncture for IBS.(Wu 2019)
IBS treatment option 4 – Hypnotherapy
Hypnotherapy has been part of National Institute of Care Excellence (NICE) guidelines for the treatment of IBS since 2008, specifically recommended for people who have had IBS for over a year with little or no benefit from conventional treatment. Using a process called Gut directed hypnotherapy, which typically takes around 6 sessions and combines imagery and suggestions to calm the digestion and reduce pain and discomfort. A recent review of psychological therapies for IBS confirmed that hypnotherapy was effective.(Ford.b. 2018) Perhaps the most interesting thing about hypnotherapy is the variety of ways in which it can be done, with research demonstrating it’s success with groups (Flik et al 2019) and via Skype. (Hasan et al 2019)
IBS treatment option 5 – Cognitive Behavioural therapy (CBT)
Often based on 6-12 sessions Cognitive behavioural therapy looks to alter assumptions about IBS and it’s triggers and symptoms with an aim to improve people ability to tolerate it whilst reducing stress induced symptoms. Research confirms that most people using it experience benefits (Ford.b. et al 2019), what is interesting is that for many this appears to be because of the symptoms changing rather than a change in psychological distress
Most of the findings are positive, however there is a lack of clarity to which approach is the best, what seems to be the way forward is a combination of dietary and psychological therapies to maximise positive outcomes. (Radu et al 2018)
Boersma, K., Ljótsson, B., Edebol-Carlman, H., Schrooten, M., Linton, S. J., & Brummer, R. J. (2016). Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects. Cognitive Behaviour Therapy, 1-16.
a.Ford, A. C., Harris, L. A., Lacy, B. E., Quigley, E. M., & Moayyedi, P. (2018). Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Alimentary pharmacology & therapeutics, 48(10), 1044-1060.
b.Ford, A. C., Lacy, B. E., Harris, L. A., Quigley, E. M., & Moayyedi, P. (2018). Effect of antidepressants and psychological therapies in irritable bowel syndrome: an updated systematic review and meta-analysis. The American journal of gastroenterology, 1.
Flik, C. E., Laan, W., Zuithoff, N. P., van Rood, Y. R., Smout, A. J., Weusten, B. L., … & de Wit, N. J. (2019). Efficacy of individual and group hypnotherapy in irritable bowel syndrome (IMAGINE): a multicentre randomised controlled trial. The Lancet Gastroenterology & Hepatology, 4(1), 20-31.
Hasan, S. S., Pearson, J. S., Morris, J., & Whorwell, P. J. (2019). SKYPE HYPNOTHERAPY FOR IRRITABLE BOWEL SYNDROME: Effectiveness and Comparison with Face-to-Face Treatment. International Journal of Clinical and Experimental Hypnosis, 67(1), 69-80.
Jankovich, E., & Watkins, A. M. (2016). Is the restriction of Fermentable Short Chain Carbohydrate (FODMAP) a credible solution for the Irritable Bowel Syndrome patient?. South African Gastroenterology Review, 14(1).
http://www.livestrong.com/article/507667-what-are-fermentable-carbohydrates/ – accessed 1 July 2016
MacPherson, H., Tilbrook, H., Agbedjro, D., Buckley, H., Hewitt, C., & Frost, C. (2016). Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial. Acupuncture in Medicine, acupmed-2015.
McKenzie, Y. A., Thompson, J., Gulia, P., & Lomer, M. C. E. (2016). British Dietetic Association systematic review of systematic reviews and evidence‐based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update). Journal of Human Nutrition and Dietetics.
Radu, M., Moldovan, R., Pintea, S., Băban, A., & Dumitrașcu, D. (2018). Predictors of outcome in cognitive and behavioural interventions for irritable bowel syndrome. A meta-analysis. Journal of Gastrointestinal & Liver Diseases, 27(3).
Ross, E., Lam, M., Andrews, C., & Raman, M. (2016). The Low FODMAPS Diet and IBS: A Winning Strategy. Journal of Clinical Nutrition & Dietetics.
Shahbazi, K., Solati, K., & Hasanpour-Dehkordi, A. (2016). Comparison of Hypnotherapy and Standard Medical Treatment Alone on Quality of Life in Patients with Irritable Bowel Syndrome: A Randomized Control Trial. Journal of Clinical & Diagnostic Research, 10(5).
Schumann, D., Klose, P., Lauche, R., Dobos, G., Langhorst, J., & Cramer, H. (2018). Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Nutrition, 45, 24-31.
Wu, I. X., Wong, C. H., Ho, R. S., Cheung, W. K., Ford, A. C., Wu, J. C., … & Chung, V. C. (2019). Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis. Therapeutic advances in gastroenterology, 12, 1756284818820438.