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Irritable bowel syndrome is a chronic gastrointestinal disease whose symptoms affect patients' daily lives. Exacerbation of symptoms can worsen patients' quality of life and lead to depressive-anxiety and somatoform disorders. The associated costs burden not only the patients, but also those around them. The etiology of IBS is multifactorial and not fully understood. The brain-gut axis remains a subject of research, which may involve the development of new, effective therapies for the treatment of IBS in the future. Pharmacological and non-pharmacological methods are used to treat IBS. In order to provide the patient with the best possible treatment results in the absence of significant side effects, research is being conducted on the possibilities of non-pharmacological patient management. Currently, there are numerous studies on the effect of physical activity on the severity of symptoms in IBS patients. The results show that the introduction of moderate-intensity physical activity has positive effects in terms of alleviating gastrointestinal symptoms, reducing the severity of psychological and somatoform symptoms, and improving patients' well-being as well as quality of life. Appropriate physical activity is acceptable to patients and rated by them as positive and having a beneficial effect on IBS symptoms. The lack of patient-reported significant side effects is important. Given the results of the study, it seems beneficial to recommend that IBS patients perform moderate physical activity to alleviate and control symptoms. It is necessary to educate patients and individualize physical activity recommendations to match the type of activity to patients' abilities and needs.

Short-term studies indicate that low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diets (LFDs) can improve symptoms for patients with irritable bowel syndrome (IBS). However, long-term (≥6 mo) effectiveness, safety, and sustainability of an LFD are not well understood and remain controversial. The primary purpose of the current review was to consider the published research on the effectiveness, safety, and sustainability of an LFD for patients with IBS. The secondary aim was to develop an infographic for dissemination to outpatient registered dietitian nutritionists and other healthcare professionals who work with patients with IBS. Three electronic databases (PubMed, Scopus, and Web of Science) were searched through December 2022, using the terms irritable bowel syndrome, FODMAP, and long-term. Following article selection, a total of 14 studies were included. Nine of 9 studies reported significant improvements in symptoms, 7 of 7 studies showed significant improvements in bowel habits, 1 of 1 study showed significantly improved disease course, and 6 of 6 studies showed significantly improved quality of life, compared to baseline. One study showed that improvement in gastrointestinal symptoms was significantly correlated with improvements in quality of life. Two of 3 studies and body composition measures indicated that nutritional adequacy was not compromised. Two of 2 studies showed that gut microbiota did not change, but 1 study showed decreased short-chain fatty acids. Adherence rates ranged from 50% to 82%, and 1 study showed that greater adherence was significantly correlated with improved IBS symptoms. Three of 3 studies showed that better adherence to an LFD was associated with improved symptom relief, and 70%-89% of participants reported satisfaction with the LFD for IBS management. The main difficulties reported were the higher expense and adhering to the diet when eating at restaurants, with family and friends, or while traveling. Overall, a long-term LFD for IBS management can be effective, safe, and sustainable. [ABSTRACT FROM AUTHOR]

Objective. The objective of this qualitative study was to examine patients' perspectives on their relationships with healthcare providers (HCPs) as communicated in their expressive writings about irritable bowel syndrome (IBS). Methods. As part of a large national online study, IBS patients were asked to: (a) write expressively about their IBS illness experience for 30 min/day for four consecutive days and (b) answer the question, ''What is the most important thing your HCP can do to maximize his/her relationship with you?'' A key word search was used to identify comments that mentioned the words ''doctor,'' ''doc,'' ''physician,'' ''MD,'' ''gastroenterologist,'' ''nurse,'' ''nurse practitioner,'' or ''physician assistant'' in the 228 expressive writings completed by the first 57 participants (four writings for each subject). Analyses of the comments about the patient--HCP relationship and responses to the above question were performed by the authors who identified themes and their frequencies over several sessions using a quantitative content analysis method. Results. We report the results of the first 57 subjects who participated in the study. Subjects' mean age was 41.1 (±± 12.7) years, gender was 82% female, 98% had seen an MD for IBS, 58% had IBS <10 years, with mild/moderate disease severity (IBS severity scale (IBSSS) 190.6 ++ 45.55), and IBS-quality of life (QOL; 62.7.3 ++ 21.58). Of the 57 subjects who wrote expressively about their experiences related to IBS, 40 (70%) wrote about their relationships with their HCPs in at least one of their four writings. Of the 197 relationship comments about HCPs made in a total of 84 writings, 106 (54%) were categorized as ''negative,'' 22 (11%) as ''positive,'' and 69 (35%) comments were categorized as ''neutral mentions.'' The top five themes identified were: ''I need more empathy and listening from my HCP about how much IBS affects my life'' (27%), ''Nothing my HCP does helps my IBS'' (25%), ''My HCP has been helpful and reassuring'' (17%), ''My HCP thinks I'm crazy'' (8%), and ''I don't trust my HCP'' (5%). Forty-nine (86%) subjects answered the question regarding maximizing the relationship with their HCP, with 53% reporting that listening, empathy, and providing education were the most important factors for maximizing the relationship. Conclusion. Our results demonstrate that the patient--HCP relationship is central to patients' illness experience. The majority of our study subjects viewed their relationships with HCPs negatively, with major concerns relating to being heard and receiving empathy. The study findings highlight the need for improved patient--HCP communication. Further research utilizing novel modalities, such as expressive writing, in eliciting patient information and perspectives, may provide valuable educational tools. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome is a common gastrointestinal disorder that is manifested by abdominal pain and an alteration in bowel habits. It is estimated to occur in approximately 20% of the US population and is diagnosed more frequently in women compared to men. The principles of management do not differ based upon gender. However, there is not data that has evaluated physician perception of IBS diagnosis and management. This study evaluated internal medicine physicians' perception of IBS in women and men. Sixty internal medicine physicians (30 men, 30 women) completed anonymous surveys evaluating their perception of the ease of diagnosis and management of IBS. A database was created and analyzed using Epi Info. Statistical significance was determined with chi-square tables that generated P values. IBS was more frequently diagnosed in women. There was a statistically significant difference in women with IBS being not easy to diagnose when compared to men with IBS (P = 0.0003). There was also a statistically significant difference in men with IBS being reported to be not easy to manage when compared to women with IBS (P = 0.0014). This study revealed that physicians perceive a difference in the ease of diagnosis and management of IBS based upon gender. Further research is necessary to gain insight into the influence of patient gender upon this disorder. [ABSTRACT FROM AUTHOR]