Tag Archives: irritable

Treatment Could Be the Most Effective Solution for Easing Irritable Bowel Syndrome

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Irritable bowel syndrome may be alleviated by techniques taught in various therapies

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A new approach that alters behaviors in individuals with irritable bowel syndrome (IBS) could prove to be more effective than traditional treatments. When offered digitally, these methods might also enhance the speed of relief.

IBS is often accompanied by symptoms such as bloating, diarrhea, constipation, and abdominal pain. While the underlying cause is not entirely understood, disruptions in gut-brain signaling are thought to play a pivotal role. Factors such as intestinal infections and certain foods can irritate the gastrointestinal tract, sending distress signals to the brain, while psychological stress can trigger the opposite response. Patients with IBS are advised to explore relaxation techniques.

While dietary recommendations and medications, like laxatives, provide relief for some, others continue to struggle with symptoms. Consequently, researchers are investigating innovative alternatives, including fecal transplants. Behavioral therapy, often seen as a last resort by physicians, may actually offer greater benefits than standard care according to a 2020 review. This approach may surpass regular treatment efficacy.

Among the methods is cognitive behavioral therapy (CBT), which empowers individuals to modify their thoughts and behaviors to better cope with and accept their symptoms, and gut-directed hypnotherapy, which induces a trance-like state prior to signaling symptom improvement.

Following the release of more studies, Alexander Ford and his colleagues at the University of Leeds in the UK, some of whom contributed to earlier reviews, conducted a comprehensive review of 67 randomized controlled trials with over 7,000 participants. These trials compared behavioral interventions lasting 4 to 12 weeks against various control groups that received conventional treatments like dietary guidance and laxatives, or those on a waiting list for intervention.

“This represents the most extensive review of behavioral treatments for irritable bowel syndrome in terms of both the number of studies and participants,” stated Perjohan Lindfors from Karolinska Institutet, Sweden.

The findings indicate that CBT and gut-directed hypnotherapy, whether in-person or via apps and the internet, are more beneficial compared to standard treatments when participants evaluated their symptoms pre- and post-treatment.

Rather than typically being provided solely in-person after standard treatments fail, the results imply that behavioral therapies can be utilized much earlier in the process. Ford remarked, “Digital solutions can help expedite the delivery of these treatments.” He further mentioned that such approaches may allow for broader implementation of behavioral therapies. However, before any updates to guidelines can be made, further trials that directly compare digital therapies with traditional treatments are required, which Ford estimates could take another five years.

Additionally, as most participants were unaware of their assigned groups, a portion of the observed benefits may stem from a placebo effect, according to Lindfors. He proposed that trials involving full treatment versus partial treatment could assist in estimating the effect size, assuming all participants genuinely believed they were receiving effective behavioral therapy.

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Source: www.newscientist.com

Gluten May Not Be the Culprit Behind Many Cases of Irritable Bowel Syndrome

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Gluten is a protein found in most types of bread.

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Some individuals believe that gluten can aggravate IBS symptoms, even though they consume proteins from wheat, barley, and rye without experiencing any discomfort.

IBS typically leads to abdominal pain, bloating, diarrhea, and constipation. Although the exact mechanism remains unclear, many affected individuals claim that gluten and its sources, which include wheat, can worsen their symptoms.

To determine the true triggers of these symptoms, Premysl Bercik and his team at McMaster University in Canada enlisted 28 participants with IBS who reported relief on a gluten-free diet.

Participants followed a gluten-free regimen for three weeks and then assessed their symptoms based on a scale from 0 to 500, averaging a score of 183.

They were then randomly given one of three types of cereal bars: one containing wheat, another with gluten alone, and a third that was free of both. The first two bars included a gluten dose similar to that found in four slices of bread, according to Bercik.

Although participants were informed that the bars may worsen their symptoms, they were unaware of the specific ingredients they contained.

After one week, participants rated the severity of their symptoms again and returned to a gluten-free diet for two weeks to reverse the effects of the bars. The experiment was repeated twice, ensuring each participant tried all three types of bars.

Following the exposure to the placebo bar, participants indicated a symptom increase of 50 points. Conversely, 11 participants reported worsening after consuming the wheat bars compared to 10 after the gluten-only bars.

Bercik notes, “All three challenges elicited symptoms in a comparable proportion of patients.”

While gluten and wheat may trigger IBS for some individuals, the findings indicate that others might be experiencing a nocebo effect.

Commentary accompanying the study by Sigrid Elsenbruch from the University of Duisburg-Essen, noted that participants were cautioned that the bars could worsen their symptoms.

Analysis of stool samples revealed that participants often did not adhere to the bar consumption as instructed. This raises the possibility that they may not have ingested sufficient gluten or wheat to specifically impact their IBS symptoms.

Bercik added that the research team is exploring how gluten and wheat might trigger IBS symptoms in some individuals, potentially by altering gut microbiota.

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Source: www.newscientist.com

Adopting a low FODMAP diet may be more effective than medication in reducing symptoms of irritable bowel syndrome

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Eating less of some types of foods and more of others may ease irritable bowel syndrome

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Two types of diets are more effective at treating irritable bowel syndrome (IBS) than drugs, a trial has found.

One diet was designed to be low in FODMAPs, a group of carbohydrates similar to sugars found in dairy products, wheat, and certain fruits and vegetables. The second, less common approach used for IBS is an adaptation of a low-carbohydrate diet that is high in fiber and low in other types of carbohydrates, such as sugar and starch.

In a randomized trial, both diets showed better symptom improvement than standard drug treatment after four weeks.

IBS can cause mysterious symptoms such as diarrhea, constipation, bloating, and abdominal pain that increase or decrease over time. The underlying cause of this condition is unknown.

The usual advice is to avoid common triggers such as caffeine, alcohol and spicy foods. Symptomatic treatments such as laxatives for constipation and drug therapy for diarrhea may be given.

If these measures don’t work, you may want to consider cutting back on foods high in FODMAPs. FODMAPs tend not to be digested until they reach the colon, which is why they are thought to cause bloating and diarrhea. This encourages the colon to retain water, and when the molecules are consumed by bacteria, gas is produced and causes bloating.

Sanna Niebacka Researchers from the University of Gothenburg in Sweden wanted to find out how a regular low-FODMAP diet compared to an alternative approach: high in fiber but low in carbohydrates. In practice, this means eating high-fat, high-protein foods such as meat and dairy products, and sources of fiber include nuts, seeds, beans, and vegetables such as cabbage.

The research team asked around 300 people with IBS to use one of three approaches depending on their symptoms: take medication or adopt one of two diets. The diet provided people with free grocery delivery, as well as detailed meal plans and recipes.

After one month, 76% of the low-FODMAP group reported a significant reduction in symptoms, compared with 71% of the low-carbohydrate diet group and 58% of the drug treatment group.

The big surprise was that a low-carbohydrate, high-fiber diet that didn’t exclude FODMAP-containing foods was about as effective as a low-FODMAP approach, Nybacka says. “We can’t answer any questions as to why. It appears that altering carbohydrate content and reducing FODMAP intake may be beneficial.”

but hazel everitt Researchers at the University of Southampton in the UK say the trial would have been more informative if it had lasted longer. “The problem with many of the IBS diets that have been proposed is that they are very difficult to stick to long-term,” she says.

Participants were followed for up to six months, but during the last five months participants who were initially offered drug treatment were also given dietary advice.

Niebacka says one potential problem with the low-carbohydrate, high-fiber diet is that this group of people had slightly elevated blood cholesterol levels. Therefore, you should seek your doctor’s advice before adopting this diet, she says.

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Source: www.newscientist.com