Non-pharmacological approach in irritable bowel syndrome therapy

Irritable bowel syndrome (IBS) is a heterogenous functional condition of the gastrointestinal (GI) tract, which significantly decreases quality of life. The Rome IV criteria classify IBS into four subtypes—with constipation, diarrhea, mixed and unsubtyped IBS. Since its pathophysiology is still not fully understood, the first line treatment should involve the non-pharmacological interventions which are free from adverse effects. The group of most important interventions includes: diet (especially low-FODMAP and classical dietary strategies such as increased fiber intake), physical activity, fecal microbiome transplantation and psychological treatment such as cognitive behavioral therapy, gut-directed hypnosis or psychodynamic interpersonal therapy. This chapter describes in brief each of these main directions in non-pharmacological treatment of IBS.