Irritable bowel syndrome (IBS), or functional colopathy, is an often painful disorder affecting the digestive system that is aggravated by stress. From a low FODMAP diet to probiotics and hypnotherapy, Guillaume Gourcerol, a gastroenterologist and hepatologist at Rouen university hospital center (CHU Rouen) in France, takes us through some of the latest and most effective approaches to treatment.
Is there a typical patient profile for people with irritable bowel syndrome (IBS)?
There is no typical profile. However, patients are 80% female and present anxious, sometimes obsessive temperaments. Half have experienced a highly stressful situation or event during childhood (sexual abuse, loss of a parent, the effects of parents' divorce, bullying at school). There are sometimes associated illnesses, such as functional dyspepsia, fibromyalgia, painful bladder syndrome, migraines, sleep disturbances, etc.
What currently available drugs are effective in treating IBS?
Antispasmodic medication, used as a long-term treatment or during flare-ups, can bring relief. In the event of small intestine bacterial overgrowth, antibiotics may be recommended.
What tests can be used to diagnose IBS?
No medical tests or procedures can diagnose the condition. It doesn't show up on an endoscopy (looking inside the body with a camera). However, patients can take tests for intolerance to lactose or fructose.
What dietary strategy can IBS sufferers adopt?
A low FODMAP diet excluding a family of poorly digested sugars (pears, apples, plums, wheat, barley, rye, legumes, artichoke, chicory, Jerusalem artichoke, Brussels sprouts), is currently one of the only dietary strategies that has been scientifically proven to improve IBS symptoms as well as quality of life for patients. It is, however, very difficult to follow long term, as FODMAPs are everywhere in foodstuffs. I recommend patients see a nutritionist or a dietician on a regular basis.
Can a gluten-free diet improve IBS?
Cutting out gluten is of no interest. Patients risk developing deficiencies or even eating disorders. In fact, when you follow a low FODMAP diet, you also remove gluten.
How is research and development advancing on new probiotics for the treatment of IBS?
Among the many strains tested in serious randomized studies, VSL3 -- sold in certain countries under the name Alflorex -- is a treatment that works. Bifidobacterium infantis 35624 and Lactobacillus plantarum 299v are among the most effective.
What kind of complementary therapy could be envisaged?
Hypnotherapy works very well for patients and this treatment can suffice in certain cases. A good relationship should be established with the practitioner who will teach the patient to self-hypnosis techniques.
Guillaume Gourcerol, a gastroenterologist and hepatologist at Rouen university hospital center (CHU Rouen) in France, will present these latest findings at the Entretiens de Bichat medical conference, held October 5-7 at the French capital's Palais des Congrès de Paris.