Irritable bowel syndrome (IBS) is a very common digestive disorder that affects a significant proportion of the population, as many as 10-15%-át may also be affected. Many people live with unpleasant symptoms such as abdominal pain, bloating, diarrhoea or constipation without knowing what is causing their problems. Diagnosing and treating IBS is often challenging, but science is constantly advancing. This article outlines the modern treatment options and scientific advances expected by 2025, which may offer new hope to those suffering from IBS.
IBS is the communication between the gut and the brain, known as „gut-brain axis” a result of this disorder. It is not a structural abnormality, but a functional disorder in which the digestive system is not functioning properly. Symptoms may come and go, intensifying at times and then subsiding, significantly impairing quality of life. The diagnosis is made by ROME IV set of criteria is made once the specialist has ruled out any other organ-related conditions with similar symptoms. It is therefore particularly important to consult a gastroenterologist about our symptoms. The Endomedix Gastroenterology Centre Our specialists use their up-to-date knowledge and modern diagnostic tools to help establish an accurate diagnosis and develop a personalised treatment plan.
In this article, we take a detailed look at current and future treatment strategies for IBS, ranging from dietary changes to the latest medicines and psychological therapies. Our aim is to provide clear, accessible information to help you understand this complex condition and the forms of support available.
The cornerstones of modern treatment for IBS
The treatment of IBS covers several areas, as the symptoms are complex and vary from person to person. Effective treatment usually consists of a combination of several approaches, tailored to the patient’s predominant symptoms. First-line treatment involves lifestyle and dietary changes, as well as certain basic medicines. If these do not bring about sufficient improvement, second-line, more specific medicines and psychological therapies may also be considered.
1. Dietary advice: The first and most important step
Professional dietary advice is essential for all patients with IBS. Diet has a significant impact on bowel function and the severity of symptoms.
Soluble and insoluble fibres
From soluble fibres (e.g. oats, barley, psyllium (also known as Egyptian plantain husk), apples, carrots) effectively alleviate the general symptoms of IBS, particularly abdominal pain. They help regulate stool consistency, so they can be useful in cases of both constipation and diarrhoea. In contrast, the indigestible fibres (e.g. wheat bran, whole grains) should be avoided, as they can make bloating and pain worse.
Low-FODMAP diet
The low-FODMAP diet is one of the most effective second-line dietary therapies for the treatment of IBS. FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) are short-chain carbohydrates that are difficult for the small intestine to digest. When fermented by gut bacteria, they produce gas, which causes bloating, cramps and abdominal pain.
The diet begins with a strict elimination phase, during which foods high in FODMAPs (e.g. wheat, onions, garlic, dairy products, certain fruits and vegetables) are removed from the diet. This is followed by a reintroduction phase, during which food groups are tested gradually, one at a time, to determine which ones the patient can tolerate and in what quantities. The diet must only be followed under the supervision of a dietitian or a specialist in gastroenterology. The dietitians at the Endomedix Gastroenterology Centre can help you structure the diet correctly and develop a personalised meal plan.
2. The role of gut flora: Probiotics and antibiotics
An imbalance in the gut flora (dysbiosis) plays an important role in the development of IBS. One of the aims of modern treatments is to restore this balance.
Probiotics
Probiotics are preparations containing beneficial bacteria that can help restore the health of the gut flora. Research shows that they can effectively alleviate the general symptoms of IBS, such as bloating and abdominal pain. It is important to note that different probiotic strains may have varying effects, and there is no single product that can be recommended for everyone. To see an improvement, it is advisable to take a particular strain for at least 4 weeks, and if there is no effect, to try another one. The duration of treatment does not usually exceed 12 weeks.
Rifaximin
Rifaximin is a minimally absorbed antibiotic used primarily to treat diarrhoea-predominant IBS (IBS-D), particularly when caused by bacterial overgrowth in the small intestine (SIBO) is available. Rifaximin reduces the number of pathogenic gut bacteria, thereby relieving bloating and diarrhoea. Its effect on abdominal pain is more limited. This medicine is also available in Hungary, but its use requires supervision by a specialist.
3. Medication: Targeted treatments for symptoms
The aim of drug therapy is to alleviate the main symptoms. Developments expected by 2025 promise even more targeted and effective medicines.
Antispasmodics and peppermint oil
Antispasmodics (spasmolytics) are widely used as first-line treatments for relieving abdominal cramps and pain. Peppermint oil is also an effective natural antispasmodic, which relaxes the intestinal muscles and reduces pain.
Medicines for regulating bowel movements
- In the event of diarrhoea (IBS-D): Loperamide is effective at reducing diarrhoea, but it may cause abdominal pain or constipation as a side effect, so the dose must be adjusted with care.
- In cases of constipation (IBS-C): Polyethylene glycol (PEG)-based laxatives can be effective in treating constipation, but they may cause bloating and abdominal pain.
New-generation, second-line medicines
If the initial treatments prove ineffective, the specialist may recommend more modern medicines with a specific mechanism of action.
- Linaclotide and Plecanatide: These guanylate cyclase-C agonists are used to treat constipation-predominant IBS (IBS-C). They increase the secretion of intestinal fluid and accelerate bowel movements, thereby relieving constipation and abdominal pain. A common side effect is diarrhoea.
- Lubiproston: This is a chloride channel activator, also used to treat IBS-C. It works in a similar way to the medicines mentioned above, but is less likely to cause diarrhoea. A common side effect is nausea.
- Eluxadolin: A medicine that acts on opioid receptors, developed for the treatment of diarrhoea-predominant IBS (IBS-D). It reduces bowel movements and the sensation of pain. Its use is contraindicated in certain conditions (e.g. gallbladder removal, alcoholism).
- 5-HT3 receptor antagonists (e.g. ondansetron): These medicines were originally used to relieve nausea, but they are also effective in treating IBS-D as they slow down bowel movements. Their most common side effect is constipation.
4. Psychological therapies: Influencing the gut-brain axis
As IBS is a disorder of the gut-brain axis, psychological factors (stress, anxiety) have a significant impact on symptoms. If conventional treatments fail to bring about any improvement after 12 months, psychological therapies should be considered.
- Cognitive behavioural therapy (CBT): It helps to identify and change the negative thought and behaviour patterns that exacerbate the symptoms.
- Gut-directed hypnotherapy: A specialised hypnotherapy technique that focuses on regulating bowel function and reducing pain.
- Mindfulness-based stress reduction: Practising mindfulness helps to reduce stress and improve your ability to cope with symptoms.
Expert assistance at Endomedix Centres
IBS is a complex condition whose diagnosis and treatment require considerable expertise. An incorrect diagnosis or inappropriate treatment can worsen the patient’s condition and quality of life. It is therefore essential to consult an experienced gastroenterologist about our symptoms.
Within the Endomedix Gastroenterology Centre’s nationwide network, patients can expect highly qualified specialists, state-of-the-art diagnostic facilities and personalised treatment plans. The centre’s specialists are up to date with the latest research findings and treatment options, enabling them to provide effective support to those suffering from IBS. As part of this comprehensive approach, dietitians and, where necessary, psychologists also support patients’ recovery.
Don’t just put up with these unpleasant symptoms! Book an appointment at your nearest Endomedix Gastroenterology Centre and take the first step towards a better quality of life.
Summary and future prospects
By 2025, the treatment of irritable bowel syndrome will increasingly shift towards personalised medicine. Thanks to scientific research, we are gaining a better understanding of the complex processes underlying the condition, including the role of gut flora, the gut-brain axis and genetic factors. This enables the development of even more targeted and effective treatments.
In the future, greater emphasis is expected to be placed on gut microbiota-based treatments, specific probiotics and digital healthcare solutions that help patients monitor their symptoms and diet. The Endomedix Gastroenterology Centre is committed to providing the most effective care possible for its patients by applying the latest scientific findings to everyday practice.
Remember, IBS is a treatable condition. With the right specialist support, personalised treatment and lifestyle changes, symptoms can be significantly alleviated, and you can regain the joy of a balanced, pain-free everyday life.
