Newer Aspects in Treatment of Irritable Bowel Syndrome: A Review

Abstract

Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder that significantly impacts quality of life, characterised by abdominal pain, bloating, and altered bowel habits without organic pathology. IBS refers to the condition where people experience abdominal pain together with abnormalities in either stool frequency or consistency. This review examines the aetiology, epidemiology, clinical features, and treatment approaches of IBS, with a focus on the role of the low FODMAP diet. IBS aetiology involves multifactorial mechanisms, including gut microbiota dysbiosis, visceral hypersensitivity, and gut-brain axis dysregulation, with a global prevalence of 10–20%. In Turkey, prevalence ranges from 6.3% to 33.5%. Diagnosis relies on symptom-based Rome IV criteria, and IBS subtypes are classified using the Bristol Stool Form Scale. A study of obese patients (BMI ≥30 kg/m²) reported a 10.5% IBS prevalence, with smoking as a significant risk factor (p=0.003). Dietary triggers, such as high-FODMAP foods, exacerbate symptoms, while the low FODMAP diet has shown efficacy in 68–86% of patients by reducing gastrointestinal symptoms through decreased osmotic load and colonic fermentation. Clinical studies support its role in improving symptom severity, nutritional status, and quality of life, as evidenced by a significant reduction in IBS-SSS scores (p<0.05). Treatment approaches include pharmacological interventions, psychological therapies, and complementary methods, with an emphasis on integrated management. The low FODMAP diet emerges as a cornerstone nutritional strategy, highlighting the importance of personalised dietary interventions in IBS management. Optimal outcomes are achieved through integrated medical, pharmacological, and nutritional interventions, forming an inseparable whole.