Irritable Bowel Syndrome (IBS): The latest insights and updates

As part of IBS awareness month, this article aims to highlight key information related to IBS including new research and innovative ideas.

What is IBS?

IBS is a gastrointestinal condition that affects around 1 in 10 people globally¹ and is associated with symptoms such as bloating, cramps and altered bowel habits which can last for varying lengths of time.²

The exact cause of IBS is unknown, but it is believed to be influenced by a range of biological, social, and psychological factors. For this reason, factors such as stress, illness, eating certain foods and medications may result in flare ups, but IBS triggers are unique to individuals.

What treatments are available for IBS?

Currently, there is no cure for IBS and therefore treatments focus on symptom management. These treatments may include dietary adjustments such as the low FOMAP diet or bulking agents if constipation is a symptom. In addition, drug therapy such as laxatives or probiotics may be helpful. Alternative therapies may also be recommended such as relaxation therapy or hypnotherapy.³

Some of the basic dietary management advice for those with IBS includes having smaller, regular meals that are not overly rich or high in fat and limiting fresh fruit to 3 portions a day. Although those with IBS are encouraged to drink regular fluids, drinks such as alcohol, caffeine and fizzy drinks should be limited.⁴

What is the low FODMAP diet and how does it relate to IBS?

Making small dietary changes may not work for everyone and so some people with IBS may be advised to try an exclusion diet such as a low FODMAP diet.

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols⁵ – which are all forms of poorly absorbed sugars that are found in a range of fruits, vegetables, dairy and wheat products.

The fermentation of FODMAPs in the bowel may trigger some of the typical IBS symptoms therefore, eating a diet low in FODMAP-containing foods may help alleviate these symptoms. 

At present, low FODMAP diets are only recommended short-term under dietetic supervision due to their restrictive nature. Due to this, FODMAP containing foods are usually slowly reintroduced after a few weeks of their elimination. Any foods introduced are then carefully monitored to help identify trigger foods. Many foods classified as high FODMAPs are also prebiotics and thus, their reintroduction is also important for maintaining a healthy gut microbiota.

What is the latest research in this area?

Many IBS sufferers find that gluten-containing foods trigger their IBS symptoms and so choose to exclude gluten from their diet. However, a recent study by Nordin et al⁶ focused on isolating gluten and FODMAPs to assess their individual impact on IBS. They found that although FODMAPs affected IBS symptoms, gluten did not. This suggests that IBS sufferers that have symptoms following consumption of gluten-containing foods may be triggered due to these foods also being high in FODMAPs rather than because they contain gluten.

Although fibre is known to have prebiotic effects which has a positive impact on our gut microbes, foods high in fibre can be a cause of discomfort for many people with IBS. However, a recent study by Harris et al⁷ indicated that the physical state of the fibre may affect the way that it is broken down by microbes during fermentation to contribute to gut health. These findings provide an exciting opportunity to design a new source of fibre for those with bowel conditions to help gain the benefits of fibre, without the discomfort.

“These data provide potential new avenues for the treatment of gastrointestinal disorders through a better control over gas and short chain fatty acid production in the colon”.

Harris et al, 2023.

Has there been any innovation in the area of IBS?

With 10% of the population suffering with IBS and the prevalence of IBS increasing as more countries begin to adopt westernised diets and lifestyles, there is an increasing demand for innovative solutions to help those living with IBS. A wide range of new apps are now available to help make tracking and managing your IBS as easy as possible. Some of these include:

• Bowelle⁸, this acts as an online food and symptom diary which produces charts and daily averages to help identify patterns between intake, stress and bowels which can then be exported and shared with healthcare professionals (HCPs).
• Caracare⁹, is a German company run by a team of HCPs with the aim of providing holistic care to those with digestive issues to help people live healthier happier lives. Based on the symptoms tracked within the app, Caracare creates a tailored plan and provides access to a live chat with a Dietitian.
• Monash FODMAP¹⁰, the research team that developed the FODMAP diet, have created an app that includes a guide to which foods are high or low in FODMAPs. They have also provided a wide range of recipes. The app helps you identify low FODMAP certified products that are available both locally and from major chains.

New companies have also designed products that make following a low FODMAP diet easy. Some examples include:

• Gutfulness¹¹, is a company that have designed a range of naturally high protein, low FODMAP bars that are free from additives and sweeteners.
• Field doctor¹², is a UK-based company that make meals tailored to your specific dietary requirements, these meals are then frozen and delivered to your door. They make a wide range of IBS-specific low FODMAP foods and desserts that are available to order. 

In summary

IBS is a condition which can have a huge impact on an individual’s confidence and quality of life¹³. That’s why talking about IBS and removing the stigma around it, as well as communicating how healthcare providers and businesses can improve the lives of people living with IBS, is such an important message to share during IBS awareness month.

References:

1.Oka, P., Parr, H., Barberio, B., Black, C.J., Savarino, E.V. and Ford, A.C. (2020). Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology, 5(10), pp.908–917. doi:https://doi.org/10.1016/s2468-1253(20)30217-x.

2. NICE (2022). Definition | Background information | Irritable bowel syndrome | CKS | NICE. [online] Nice.org.uk. Available at: https://cks.nice.org.uk/topics/irritable-bowel-syndrome/background-information/definition/ [Accessed 19 Apr. 2023]

3. Guts UK. (2022). Irritable Bowel Syndrome | Causes, Symptoms & Treatment | Guts UK. [online] Available at: https://gutscharity.org.uk/advice-and-information/conditions/irritable-bowel-syndrome/ [Accessed 19 Apr. 2023].

4. BDA (2023). Irritable Bowel Syndrome Food Fact Sheet. [online] Uk.com. Available at: https://www.bda.uk.com/resource/irritable-bowel-syndrome-diet.html [Accessed 19 Apr. 2023].

5. IBS Network (2023). FODMAPS | The IBS Network. [online] Theibsnetwork.org. Available at: https://www.theibsnetwork.org/diet/fodmaps/ [Accessed 19 Apr. 2023].

6. Gutfulness (2023). Gutfulness. [online] Available at: https://gutfulness.co.uk/ [Accessed 19 Apr. 2023].

7. Harris, H.C., Pereira, N., Koev, T., Khimyak, Y.Z., Yakubov, G.E. and Warren, F.J. (2023). The impact of psyllium gelation behaviour on in vitro colonic fermentation properties. Food Hydrocolloids, [online] 139, p.108543. doi: https://doi.org/10.1016/j.foodhyd.2023.108543.

8. Bowelle AB (2018). Bowelle – The IBS tracker. [online] App Store. Available at: https://apps.apple.com/us/app/bowelle-the-ibs-tracker/id1436064640 [Accessed 19 Apr. 2023].

9. Cara Care (2023). Cara Care. [online] Cara.care. Available at: https://cara.care/en-gb/ [Accessed 19 Apr. 2023].

10. MONASH University (2019). Low FODMAP Diet App | Monash FODMAP – Monash Fodmap. [online] Monashfodmap.com. Available at: https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/ [Accessed 19 Apr. 2023].

11. Gutfulness (2023). Gutfulness. [online] Available at: https://gutfulness.co.uk/ [Accessed 19 Apr. 2023].

12. Field Doctor. (2023). Field Doctor – Feed Your Health. [online] Available at: https://www.fielddoctor.co.uk/ [Accessed 19 Apr. 2023].

13. Lane, C. (2023). IBS Awareness Month 2023. [online] Guts UK. Available at: https://gutscharity.org.uk/2023/04/ibs-awareness-month-2023/ [Accessed 19 Apr. 2023].

Founded and led by a registered dietitian, our team offers a full-service agency approach to all medical and nutrition marketing needs. Based on the latest industry guidelines and research, our medical and nutrition information is always evidence-based, accurate and up-to-date. If you’d like further information on how we can help your business deliver evidence-based educational content, contact us here.