A literature review on non-pharmacological treatments for irritable bowel syndrome (IBS)
DOI:
https://doi.org/10.12775/JEHS.2025.80.59107Keywords
irritable bowel syndrome, non-pharmacological treatment, dietary, FODMAP, brain-gut axisAbstract
Introduction
Irritable bowel syndrome (IBS) is a prevalent condition involving the gut–brain interaction where
individuals commonly experience recurring abdominal pain, changes in bowel movements, and
frequently bloating.
Aim
The aim of this study was to review literature studies on IBS and non-pharmacological methods for
treating this condition.
Method
Data for the article were retrieved by using Pub Med setting the time descriptor to 2019-2024.
Conclusions
Treating irritable bowel syndrome (IBS) continues to be challenging, as each patient needs a
tailored approach. Once the correct IBS subtype is diagnosed, treatment should target the primary
symptoms, such as bloating or diarrhea. Non-pharmacological treatment plays a initial, crucial and
rapidly developing role in IBS therapy.
References
[1] Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome:
a meta-analysis. Clin Gastroenterol Hepatol. 2012; 10: 712-721.e4.
[2] Mearin F, Lacy BE, Chang L, et al. Bowel disorders. Gastroenterology. 2016;
S0016-5085(16)00222-5
[3] Fagoonee, S, Pellicano, R. Does the microbiota play a pivotal role in the pathogenesis of
irritable bowel syndrome? J Clin Med. 2019; 8: 1808.
[4] Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features
and Rome IV. Gastroenterology. 2016; 150: 1262-1279.
[5] Chojnacki C, Błońska A, Kaczka A, et al. Evaluation of serotonin and dopamine secretion and
metabolism in patients with irritable bowel syndrome. Pol Arch Intern Med. 2018; 128: 711-713.
[6] Mei L, Zhou J, Su Y, et al. Gut microbiota composition and functional prediction in diarrhea-
predominant irritable bowel syndrome. BMC Gastroenterol. 2021; 21: 105.
[7] Polster A, Öhman L, Tap J, et al. A novel stepwise integrative analysis pipeline reveals distinct
microbiota-host interactions and link to symptoms in irritable bowel syndrome. Sci Rep. 2021; 11:
5521
[8] Adriani A, Ribaldone DG, Astegiano M, et al. Irritable bowel syndrome: the clinical approach.
Panminerva Med. 2018; 60: 213-222.
[9] Tap J, Störsrud S, Le Nevé B, et al. Diet and gut microbiome interactions of relevance for
symptoms in irritable bowel syndrome
[10] Ford AC, Sperber AD, Corsetti M, Camilleri M. Irritable bowel syndrome. Lancet. 2020; 396:
1675-1688.
[11] Vasant DH, Paine PA, Black CJ, et al. British Society of Gastroenterology guidelines on
the management of irritable bowel syndrome. Gut. 2021; 70: 1214-1240.
[12] Irritable bowel syndrome in adults: diagnosis and management. London, United Kingdom:
National Institute for Health and Care Excellence; 2017.
[13] Black CJ, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel
syndrome: systematic review and network meta-analysis. Gut. 2022; 71:1117-1126
[14] Wu J, Masuy I, Biesiekierski JR, Fitzke HE, Parikh C, Schofield L, Shaikh H, Bhagwanani
A, Aziz Q, Taylor SA, Tack J, Van Oudenhove L. Gut-brain axis dysfunction underlies FODMAP-
induced symptom generation in irritable bowel syndrome. Aliment Pharmacol
Ther. 2022;55:670-682.
[15] Chey WD, Hashash JG, Manning L, Chang L. AGA Clinical Practice Update on the Role of
Diet in Irritable Bowel Syndrome: Expert Review. Gastroenterology. 2022;162:1737-1745.e5.
[16] Schumann D, Klose P, Lauche R, Dobos G, Langhorst J, Cramer H. Low fermentable, oligo-,
di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic
review and meta-analysis. Nutrition. 2018;45:24-31.
[17] Surdea-Blaga T, Cozma-Petrut A, Dumitraşcu DL. Dietary interventions and irritable bowel
syndrome – what really works?. Curr Opin Gastroenterol. 2021;37(2):152–157
[18] Adriani A, Saracco GM, Pellicano R. Irritable bowel syndrome and lactose intolerance:
a challenging overlap. Minerva Gastroenterol. 2021; 67: 67-68.
[19] Dumitrascu DL, Baban A, Bancila I, Barboi O, et al. Romanian Guidelines for
Nonpharmacological Therapy of IBS. J Gastrointestin Liver Dis. 2021;30(2):291–306. doi:
10.15403/jgld-3581.
[20] El-Salhy M, Hatlebakk JG, Hausken T. Diet in Irritable Bowel Syndrome (IBS): Interaction
with Gut Microbiota and Gut Hormones. Nutrients. 2019;11(8):1824. doi: 10.3390/nu11081824.
[21] Ford AC, Lacy BE, Talley NJ. Irritable Bowel Syndrome. N Engl J Med. 2017;376:2566–
2578. doi: 10.1056/NEJMra1607547
[22] Nagarajan N, Morden A, Bischof D, King EA, et al. The role of fiber supplementation in the
treatment of irritable bowel syndrome: a systematic review and meta-analysis. Eur J Gastroenterol
Hepatol. 2015;27:1002–1010. doi: 10.1097/MEG.0000000000000425
[23] Moayyedi P, Quigley EM, Lacy BE, Lembo AJ, et al. The effect of fiber supplementation on
irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol.
2014;109(9):1367–1374. doi: 10.1038/ajg.2014.195.
[24] McRorie JW. Evidence-Based Approach to Fiber Supplementsand Clinically Meaningful
Health Benefits, Part 1: What to Look for and How to Recommend an Effective Fiber Therapy. Nutr
Today. 2015;50:82–89. doi: 10.1097/NT.0000000000000082
[25] Moayyedi P, Andrews CN, MacQueen G, Korownyk C, et al. Canadian Association of
Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome
(IBS). J Can Assoc Gastroenterol. 2019 Apr;2(1):6–29. doi: 10.1093/jcag/gwy071
[26] Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, et al. Soluble or insoluble fibre in irritable
bowel syndrome in primary care?Randomised placebo controlled trial. BMJ. 2009;339:b3154. doi:
10.1136/bmj.b3154.
[27] Muir J. An Overview of Fiber and Fiber Supplements for Irritable Bowel Syndrome.
Gastroenterol Hepatol (N Y) 2019;15:387–389.
[28] Toskes PP, Connery KL, Ritchey TW. Calcium polycarbophil compared with placebo in
irritable bowel syndrome. Aliment Pharmacol Ther. 1993;7(1):87–92. doi: 10.1111/
j.1365-2036.1993.tb00074.x.
[29] McKenzie YA, Bowyer RK, Leach H, Gulia P, et al. British Dietetic Association systematic
review and evidence-based practice guidelines for the dietary management of irritable bowel
syndrome in adults (2016 update). J Hum Nutr Diet. 2016 Oct;29(5):549–75. doi: 10.1111/
jhn.12385.
[30] Hill C, Guarner F, Reid G, Gibson GR, et al. Expert consensus document. The International
Scientific Association for Probiotics and Prebiotics consensus statement on the scope and
appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506–14. doi:
10.1038/nrgastro.2014.66.
[31] Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome:
New therapeutic strategies. World J Gastroenterol. 2016;22(7):2219–2241. doi: 10.3748/
wjg.v22.i7.2219.
[32] Thursby E, Juge N. Introduction to the human gut microbiota. Biochem J. 2017 May
16;474(11):1823–1836. doi: 10.1042/BCJ20160510.
[33] Rodiño-Janeiro BK, Vicario M, Alonso-Cotoner C, Pascua-García R, Santos J. A Review of
Microbiota and Irritable Bowel Syndrome: Future in Therapies. Adv Ther. 2018;35(3):289–310.
doi: 10.1007/s12325-018-0673-5
[34] McKenzie YA, Thompson J, Gulia P, Lomer MC, (IBS Dietetic Guideline Review Group on
behalf of Gastroenterology Specialist Group of the British Dietetic Association) 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). J Hum
Nutr Diet. 2016;29(5):576–592. doi: 10.1111/jhn.12386
[35] Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P. Systematic review with meta-
analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel
syndrome. Aliment Pharmacol Ther. 2018 Nov;48(10):1044–1060. doi: 10.1111/apt.15001.
[36] Fukudo S, Okumura T, Inamori M, Okuyama Y, et al. Evidence-based clinical practice
guidelines for irritable bowel syndrome 2020. J Gastroenterol. 2021;56(3):193–217. doi: 10.1007/
s00535-020-01746-z
[37] Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based
medicine. World J Gastroenterol. 2014; 20: 6759-6773.
[38] Chen GR, Xie XF, Peng C. Treatment of Irritable Bowel Syndrome by Chinese Medicine: A
Review. Chin J Integr Med. 2023;29:377-384
[39] Chen M, Qin D, Huang SL, et al. Chinese herbal medicine versus antispasmodics in
the treatment of irritable bowel syndrome: a network meta-analysis. Neurogastroenterol Motil. 2021
Mar 4.
[40] WHO Guideline. Physical Activity. Updated 5 October 2022.
[41] NICE. Irritable Bowel Syndrome in Adults: Diagnosis and Management; NICE Clinical
Guidelines, No. 61; National Institute for Health and Care Excellence (NICE): London, UK, 2017.
[42] Jiang ZD, Ajami NJ, Petrosino JF, et al. Randomised clinical trial: faecal microbiota
transplantation for recurrent Clostridium difficile infection – fresh, or frozen, or lyophilised
microbiota from a small pool of healthy donors delivered by colonoscopy. Aliment Pharmacol Ther.
2017; 45: 899-908.
[43] Johnsen PH, Hilpüsch F, Cavanagh JP, et al. Faecal microbiota transplantation versus placebo
for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled,
parallel-group, single-centre trial. Lancet Gastroenterol Hepatol. 2018; 3: 17-24.
[44] Halkjær SI, Christensen AH, Lo BZS, et al. Faecal microbiota transplantation alters gut
microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind
placebo-controlled study. Gut. 2018; 67: 2107-2115.
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Copyright (c) 2025 Wojciech Urban, Kornelia Karamus, Rafał Wojciech Rejmak, Jan Biłogras, Martyna Borowska-Łygan, Konrad Strużek, Jakub Tomaszewski
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