THE EFFECTIVENESS OF PHARMACOLOGICAL, DIETARY, PSYCHOLOGICAL AND NOVEL TREATMENTS IN IRRITABLE BOWEL SYNDROME
Abstract
Research objectives: Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract with a complex pathogenesis in which the brain-gut axis is disrupted. Due to the multifactorial basis of the disorder, it is very important to combine pharmacological and psychological treatment with dietary treatment to alleviate patients' symptoms.
The purpose of this dissertation was to present the effectiveness of pharmacological, dietary, psychological and novel treatments currently at research level in patients with irritable bowel syndrome.
Method: In order to evaluate the effectiveness of various therapies in IBS, a systematic review was conducted. It covers articles from years 2020 - 2024, that were published in PubMed, MDPI, and Sage Journals databases.
Key Findings: The treatment of irritable bowel syndrome requires a combination of different therapies to achieve an effective therapeutic effect. There is no specific form of treatment to cure IBS.
Conclusions: Currently it is only possible to alleviate the discomfort and improve the quality of life by combining the various methods available. The method that seems to be the most effective is a combination of pharmacological, dietary and psychological treatment. Pharmacological therapy makes it possible to alleviate pain, constipation or diarrhea. The introduction of the FODMAP diet eliminates factors that adversely affect the intestinal microbiota, and psychotherapy, combined with pharmacological treatment of depression and anxiety, alters thinking and synthesizes hormones that affect the gut-brain axis. Alternative treatments are currently being researched, but it will take time and further research before these methods can be incorporated into standard therapy.
References
Djatioetomo, A. K., Maharani, A. R., Djatioetomo, Y. C., Nurrochmawati, Z., & Anandita, F. A. (2024). Low-FODMAP diet on postprandial distress syndrome type of functional dyspepsia with mixed type of irritable bowel syndrome patient: A case report. Narra Journal, 4(2), e759. https://doi.org/10.52225/narra.v4i2.759
Vernon-Roberts, A., Alexander, I., & Day, A. S. (2021). Systematic review of pediatric functional gastrointestinal disorders (Rome IV criteria). Journal of Clinical Medicine, 10(21), 5087. https://doi.org/10.3390/jcm10215087
Mayer, E. A., Ryu, H. J., & Bhatt, R. R. (2023). The neurobiology of irritable bowel syndrome. Molecular Psychiatry, 28(4), 1451–1465. https://doi.org/10.1038/s41380-023-01972-w
Camilleri, M., & Boeckxstaens, G. (2023). Irritable bowel syndrome: Treatment based on pathophysiology and biomarkers. Gut, 72(3), 590–599. https://doi.org/10.1136/gutjnl-2022-328515
Huang, K. Y., Wang, F. Y., Lv, M., Ma, X. X., Tang, X. D., & Lv, L. (2023). Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment. World Journal of Gastroenterology, 29(26), 4120–4135. https://doi.org/10.3748/wjg.v29.i26.4120
Dothel, G., Barbaro, M. R., Di Vito, A., Ravegnini, G., Gorini, F., Monesmith, S., Coschina, E., Benuzzi, E., Fuschi, D., Palombo, M., Bonomini, F., Morroni, F., Hrelia, P., Barbara, G., & Angelini, S. (2023). New insights into irritable bowel syndrome pathophysiological mechanisms: Contribution of epigenetics. Journal of Gastroenterology, 58(7), 605–621. https://doi.org/10.1007/s00535-023-01997-6
Goodoory, V. C., & Ford, A. C. (2023). Antibiotics and probiotics for irritable bowel syndrome. Drugs, 83(8), 687–699. https://doi.org/10.1007/s40265-023-01871-y
Altomare, A., Di Rosa, C., Imperia, E., Emerenziani, S., Cicala, M., & Guarino, M. P. L. (2021). Diarrhea predominant-irritable bowel syndrome (IBS-D): Effects of different nutritional patterns on intestinal dysbiosis and symptoms. Nutrients, 13(5), 1506. https://doi.org/10.3390/nu13051506
Moazzam, S. W., Mobeen, A., & Siddiqui, M. A. (2022). Efficacy of Jawarish Shahi a herbal formulation in irritable bowel syndrome: An open-labeled single-arm clinical trial. Journal of Traditional and Complementary Medicine, 12(6), 529–535. https://doi.org/10.1016/j.jtcme.2022.04.004
Chey, W. D., Shah, E. D., & DuPont, H. L. (2020). Mechanism of action and therapeutic benefit of rifaximin in patients with irritable bowel syndrome: A narrative review. Therapeutic Advances in Gastroenterology, 13, 1756284819897531. https://doi.org/10.1177/1756284819897531
Bor, S., Lehert, P., Chalbaud, A., & Tack, J. (2021). Efficacy of pinaverium bromide in the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Therapeutic Advances in Gastroenterology, 14, 17562848211033740. https://doi.org/10.1177/17562848211033740
Khan, A., Menon, R., Corning, B., Cohn, S., Kumfa, C., & Raji, M. (2024). Mirtazapine for gastrointestinal and neuropsychological symptoms in older adults with irritable bowel syndrome. Therapeutic Advances in Gastroenterology, 18, 17562848241278125. https://doi.org/10.1177/17562848241278125
Galica, A. N., Galica, R., & Dumitrașcu, D. L. (2022). Diet, fibers, and probiotics for irritable bowel syndrome. Journal of Medicine and Life, 15(2), 174–179. https://doi.org/10.25122/jml-2022-0028
Czerwińska Pawluk, I., Pawluk, E. P., Szymaszek, A. D., & Badiuk, N. S. (2020). The role of nursing staff in feeding a child with cystic fibrosis. Pedagogy and Psychology of Sport, 6(2), 18–29. https://doi.org/10.12775/PPS.2020.06.02.002
Colomier, E., Van Oudenhove, L., Tack, J. L., Böhn, L., Bennett, S., Nybacka, S., Störsrud, S., Öhman, L., Törnblom, H., & Simrén, M. (2022). Predictors of symptom-specific treatment response to dietary interventions in irritable bowel syndrome. Nutrients, 14(2), 397. https://doi.org/10.3390/nu14020397
Bertin, L., Zanconato, M., Crepaldi, M., Marasco, G., Cremon, C., Barbara, G., Barberio, B., Zingone, F., & Savarino, E. V. (2024). The role of the FODMAP diet in IBS. Nutrients, 16(3), 370. https://doi.org/10.3390/nu16030370
Thomas, A., Thomas, A., & Butler-Sanchez, M. (2021). Dietary modification for the restoration of gut microbiome and management of symptoms in irritable bowel syndrome. American Journal of Lifestyle Medicine, 16(5), 608–621. https://doi.org/10.1177/15598276211012968
Black, C. J., Staudacher, H. M., & Ford, A. C. (2022). Efficacy of a low FODMAP diet in irritable bowel syndrome: Systematic review and network meta-analysis. Gut, 71(6), 1117–1126. https://doi.org/10.1136/gutjnl-2021-325214
Ceccherini, C., Daniotti, S., Bearzi, C., & Re, I. (2022). Evaluating the efficacy of probiotics in IBS treatment using a systematic review of clinical trials and multi-criteria decision analysis. Nutrients, 14(13), 2689. https://doi.org/10.3390/nu14132689
Machała-Ćwikła, E., Łapińska, U., Zdziebło, P., Ćwikła, P., Machała, K., Szeląg, K., Machala, D., Kujawski, A., Zuzak, A. P., & Zdziebło, K. (2024). Effect of physical activity on the severity of irritable bowel syndrome (IBS) symptoms. Quality in Sport, 16, 52921. https://doi.org/10.12775/QS.2024.16.52921
Cuber, I., Aghadi, A., Białowąs, E., Dybała, E., & Mazurek, M. (2023). Irritable bowel syndrome – A literature review. Journal of Education, Health and Sport, 13(4), 53–62. https://doi.org/10.12775/JEHS.2023.13.04.005
Staudacher, H. M., Black, C. J., Teasdale, S. B., Mikocka-Walus, A., & Keefer, L. (2023). Irritable bowel syndrome and mental health comorbidity: Approach to multidisciplinary management. Nature Reviews Gastroenterology & Hepatology, 20(9), 582–596. https://doi.org/10.1038/s41575-023-00794-z
Slouha, E., Patel, B., Mohamed, A., Razeq, Z., Clunes, L. A., & Kollias, T. F. (2023). Psychotherapy for irritable bowel syndrome: A systematic review. Cureus, 15(12), e51003. https://doi.org/10.7759/cureus.51003
Algera, J., Lövdahl, J., Sjölund, J., Tornkvist, N. T., & Törnblom, H. (2023). Managing pain in irritable bowel syndrome: Current perspectives and best practice. Expert Review of Gastroenterology & Hepatology, 17(9), 871–881. https://doi.org/10.1080/17474124.2023.2242775
Donnet, A. S., Hasan, S. S., & Whorwell, P. J. (2022). Hypnotherapy for irritable bowel syndrome: Patient expectations and perceptions. Therapeutic Advances in Gastroenterology, 15, 17562848221074208. https://doi.org/10.1177/17562848221074208
Halkjær, S. I., Lo, B., Cold, F., Højer Christensen, A., Holster, S., König, J., Brummer, R. J., Aroniadis, O. C., Lahtinen, P., Holvoet, T., Gluud, L. L., & Petersen, A. M. (2023). Fecal microbiota transplantation for the treatment of irritable bowel syndrome: A systematic review and meta-analysis. World Journal of Gastroenterology, 29(20), 3185–3202. https://doi.org/10.3748/wjg.v29.i20.3185
Ribichini, E., Scalese, G., Mocci, C., & Severi, C. (2024). Gut-brain axis and psychopathology: Exploring the impact of diet with a focus on the low-FODMAP approach. Nutrients, 16(20), 3515. https://doi.org/10.3390/nu16203515
Bonaz, B. (2022). Anti-inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction. Neurogastroenterology & Motility, 34(10), e14456. https://doi.org/10.1111/nmo.14456
Mogilevski, T., Rosella, S., Aziz, Q., & Gibson, P. R. (2022). Transcutaneous vagal nerve stimulation protects against stress-induced intestinal barrier dysfunction in healthy adults. Neurogastroenterology & Motility, 34(10), e14382. https://doi.org/10.1111/nmo.14382
Dai, Y.-K., Wu, Y.-B., Li, R.-L., Chen, W.-J., Tang, C.-Z., Lu, L.-M., & Hu, L. (2020). Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults. World Journal of Gastroenterology, 26(41), 6488–6509. https://doi.org/10.3748/wjg.v26.i41.6488
Bonetto, S., Fagoonee, S., Battaglia, E., Grassini, M., Saracco, G. M., & Pellicano, R. (2021). Recent advances in the treatment of irritable bowel syndrome. Polish Archives of Internal Medicine, 131(7–8), 709–715. https://doi.org/10.20452/pamw.16067
Views:
23
Downloads:
10
Copyright (c) 2025 Dominika Gieroba, Anna Kamieniak, Weronika Perczyńska, Gabriela Kapłon, Julia Szczotka, Gabriela Szpila, Artur Tumiński, Marianna Chmiel, Aleksandra Sokół, Remigiusz Flakus, Żaneta Kania, Karolina Glajcar

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.