Management Of Irritable Bowel Syndrome Research Articles

Central Neuromodulators in Irritable Bowel Syndrome: Why, How, and When.

Irritable bowel syndrome (IBS) is responsive to treatments using central neuromodulators. Central neuromodulators work by enhancing the synaptic transmission of 5-hydroxytryptamine, noradrenalin, and dopamine, achieving a slower regulation or desensitization of their postsynaptic receptors. Central neuromodulators act on receptors along the brain-gut axis, so they are useful in treating psychiatric comorbidities, modifying gut motility, improving central downregulation of visceral signals, and enhancing neurogenesis in patients with IBS. Choosing a central neuromodulator for treating IBS should be according to the pharmacological properties and predominant symptoms. The first-line treatment for pain management in IBS is using tricyclic antidepressants. An alternative for pain management is the serotonin and noradrenaline reuptake inhibitors. Selective serotonin reuptake inhibitors are useful when symptoms of anxiety and hypervigilance are dominant but are not helpful for treating abdominal pain. The predominant bowel habit is helpful when choosing a neuromodulator to treat IBS; selective serotonin reuptake inhibitors help constipation, not pain, but may cause diarrhea; tricyclic antidepressants help diarrhea but may cause constipation. A clinical response may occur in 6-8 weeks, but long-term treatment (usually 6-12 months) is required after the initial response to prevent relapse. Augmentation therapy may be beneficial when the therapeutic effect of the first agent is incomplete or associated with side effects. It is recommended to reduce the dose of the first agent and add a second complementary treatment. This may include an atypical antipsychotic or brain-gut behavioral treatment. When tapering central neuromodulators, the dose should be reduced slowly over 4 weeks but may take longer when discontinuation effects occur.

Real-world outcomes for a digital prescription mobile application for adults with irritable bowel syndrome.

Mahana™ IBS is a Food and Drug Administration-cleared prescription mobile application designed to deliver 3 months of gut-directed cognitive behavioral therapy (CBT) to adults ≥22 years old with irritable bowel syndrome (IBS). We assessed whether gut-directed CBT delivered digitally improved outcomes in IBS management. We studied users who had a dispensed physician prescription for Mahana™ IBS between August 2021 and August 2023. The primary outcome was change in IBS symptom severity (IBS-SSS) score. For the 843 patients, 324 (38%) completed half of the program up to session 5, and 162 (19%) of participants completed the full program up to session 10. Median age was 41 years, median IBS-SSS was 270 (moderate severity), IBS-mixed subtype was most common (23%) followed by IBS-C (20%) and IBS-D (19%). The change in IBS-SSS was -81.0 (p = < 0.001) after session 5 and - 104.4 (p = < 0.001) after session 10. In multivariate analyses, a higher baseline IBS-SSS (OR 1.59; 95% CI 1.26-2.01) and high baseline Perceived Stress Scale (PSS) score predicted non-response (OR 0.95; 95% CI 0.91-0.98) while older age (OR 1.10 per decade; 95% CI 1.01-1.20), prescription source from a healthcare provider (as opposed to third party telehealth encounter, OR 1.48; 95% CI 1.07-2.05), and payment for the app (OR 1.93; 95% CI 1.41-2.63) predicted adherence. Use of a digital mobile application for gut-directed CBT improved symptoms of IBS. Digital health applications have the potential to democratize CBT and allow integrated care to scale for patients with IBS.

The Possible Synergistic Pharmacological Effect of an Oral Berberine (BBR) and Curcumin (CUR) Complementary Therapy Alleviates Symptoms of Irritable Bowel Syndrome (IBS): Results from a Real-Life, Routine Clinical Practice Settings-Based Study.

Irritable bowel syndrome (IBS) is a prevalent chronic functional gastrointestinal disorder, characterised by recurrent abdominal discomfort and altered bowel movements. IBS cause a significantly negative impact on quality of life (QoL). Growing pharmacological evidence suggests that berberine (BBR) and curcumin (CUR) may mitigate IBS symptoms through multiple complementary synergistic mechanisms, resulting in the attenuation of intestinal inflammation and regulation of bowel motility and gut functions. In the present observational study conducted under real-life routine clinical practice settings, 146 patients diagnosed with IBS were enrolled by general practitioner clinics and pharmacies in Belgium. For the first time, this study assessed the potential synergistic pharmacological effect of a combined oral BBR/CUR supplement (Enterofytol® PLUS, containing 200 mg BBR and 49 mg CUR) (two tablets daily for 2 months), serving as complementary therapy in the management of IBS. Following the 2-month supplementation, significant improvements were observed in the patients' IBS severity index (IBSSI) (47.5%) and all the primary IBS symptoms, such as abdominal discomfort (47.2%), distension (48.0%), intestinal transit (46.8%), and QoL (48.1%) (all p < 0.0001). The improvement in the patients' IBSSI was independent of age, sex, and IBS sub-types. The patients' weekly maximum stool passage frequency decreased significantly (p < 0.0001), and the stool status normalized (p < 0.0001). The patients' need for concomitant conventional IBS treatment decreased notably: antispasmodics by 64.0% and antidiarrhoeals by 64.6%. Minor adverse effects were reported by a small proportion (7.1%) of patients, mostly gastrointestinal. The majority (93.1%) experienced symptom improvement or resolution, with a high satisfaction rate (82.6%) and willingness to continue the supplementation (79.0%). These findings support the potential synergistic pharmacological role of BBR and CUR in IBS, and their co-supplementation may alleviate IBS symptoms and improve QoL.

The role of cognitive emotion regulation strategies in predicting the resilience, symptom severity, and quality of life of patients with irritable bowel syndrome

BackgroundPsychosocial stressors contribute to the development of irritable bowel syndrome (IBS) and exacerbate the symptoms. The capability to cope with stress is an essential element in the management of IBS. This study assessed nine cognitive emotion regulation strategies (CERS) and their role in predicting symptom severity, quality of life (QOL), and resilience in IBS subjects. MethodsThe scores regarding nine subscales of CERS were obtained by cognitive emotion regulation questionnaire (CERQ) and compared between study patients based on the severity and subtypes of IBS using one-way ANOVA. To evaluate the predictive role of CERS, logistic regression was performed. The correlation between CERS and the QOL was assessed by Pearson correlation analysis. The score of resilience was measured by Connor-Davidson Resilience Scale (CD-RISC). ResultsWe recruited 100 patients diagnosed with IBS based on ROME IV criteria. Among nine subscales of CERS, patients with more severe symptoms scored higher in catastrophizing (p < 0.001) and blaming others (p = 0.015) while lower in positive reappraisal (p = 0.028). Blaming others was the only predictor of resilience and severity of IBS in our patients (odds ratio (OR): -2.103, p=0.028, and OR:1.715, p = 0.049, respectively). We observed significant negative correlations between the quality of life and rumination (r= -0.202, p=0.044), self-blame (r= -0.241, p=0.016), catastrophizing (r= -0.342, p<0.001), and blaming others (r= -0.219, p=0.028). ConclusionMaladaptive strategies are more common in IBS patients with more severe symptoms and have negative correlations with the QOL. Blaming others has the potential to predict the resilience and severity of symptoms in IBS patients.

Prevalence and Associated Risk Factors of Irritable Bowel Syndrome Among General Population: A Cross-Sectional Study in Qassim Region, Saudi Arabia.

Background Irritable bowel syndrome (IBS) affects 10-20% of the global population, primarily manifesting as functional issues leading to abdominal discomfort. Key contributors like genetics, psychological factors, weakened immunity, and environmental pollutants play significant roles. Regional variations exist, with prevalence rates ranging from 7-10% in certain areas like South Asia and the Middle East to as high as 20% in many Western countries. Objective The objective of this study is to assess the prevalence of irritable bowel syndrome (IBS) and its related risk factors among the general populace of the Qassim region, Saudi Arabia, aiming to offer valuable insights for healthcare planning and intervention strategies. Methods A cross-sectional descriptive study was conducted, utilizing a validated self-administered questionnaire among residents of the Qassim region aged over 18 years. The questionnaire included demographic information about the participants and the validated Rome IV questionnaire for IBS in adults. Ethical approval for the study was obtained from the Qassim Research Ethics Committee, and data analysis was conducted using R script language version 4.3.3. A significance level of p < 0.05 was employed to interpret the results. Results Overall, significant associations were observed between IBS diagnosis and food allergy (AOR = 2.34, 99% CI: 1.27-4.29), family history of IBS (Adjusted Odd Ratio (AOR) = 7.03, 99% CI: 3.51-15.74), and abdominal pain lasting more than six months (AOR = 2.54, 99% CI: 1.49-4.33). Conclusion This study highlights a high IBS prevalence (21.4%) in Saudi Arabia's Qassim region. While no overall soda-IBS link was found, males showed a protective effect. Significant associations were noted between food allergy, family history, and abdominal pain with IBS diagnosis, especially among females. Further research on gender disparities and familial and abdominal pain roles in IBS management is warranted.

Management of irritable bowel syndrome: a narrative review.

As our understanding of the pathophysiology of irritable bowel syndrome (IBS) has advanced, so too has the therapeutic landscape, offering a myriad of approaches to alleviate symptoms and enhance the well-being of patients. This review paper is dedicated to a comprehensive exploration of the diverse therapeutic modalities available for managing IBS. By delving into the complexities of IBS therapeutics, our aim is to contribute to the enhancement of patient care and the overall quality of life for patients grappling with this complex condition. This review utilized information from PubMed/MEDLINE using the key search term "irritable bowel syndrome" as well as the 2020 American College of Gastroenterology (ACG) and 2022 American Gastroenterological Association (AGA) society guidelines on IBS. The search was restricted to articles in the English language only and included peer-reviewed observational studies and randomized controlled trials (RCTs) in adult patients from April 22, 2020 to October 16, 2023. This review will start with an overview of the current guidelines for pharmacologic therapies for IBS as recommended by the ACG and the AGA, with an emphasis on clinical trials published after the most recent guidelines. It will then delve into the literature on dietary modifications, probiotics, fecal microbiota transplant, behavioral therapy, and complementary and alternative medicine approaches to IBS. It is evident that the management of IBS has transcended a one-size-fits-all approach. As the field of IBS management continues to evolve, it is imperative for physicians to stay informed and receptive to the array of therapeutic options available, ultimately providing patients with the most effective and personalized care.

Dietetic management of irritable bowel syndrome: A national survey of dietary approaches and decision-making factors

Dietetic management of irritable bowel syndrome: A national survey of dietary approaches and decision-making factors

Starting a career in research nursing during a global pandemic.

In the spring of 2020, two nurses (KR and AJ) commenced their research nurse careers amid the SARS-Cov-2 (COVID-19) global pandemic. This reflective article discusses their experiences of beginning a clinical research nursing career, presented as a case study of their learning journey, rather than detailing the randomised controlled trial they delivered via GP practices. The main study compared standard care to nurse-led management of irritable bowel syndrome, the details of which will be published separately. The article identifies three overarching concepts: 'Green as grass, keen as mustard', 'Spires and steeples', and 'Down the rabbit hole'. The article offers insight from the two nurses for other professionals contemplating a career in research.

The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that has a significant impact on the general population. The suboptimal medical treatments available for IBS contribute to its large economic burden. The pathophysiology of IBS is complex, and treatments often focus on managing specific symptoms. Many individuals with IBS associate their symptoms with specific food intake, leading to increased scientific research on the role of diet in managing IBS. Dietary management has become a crucial aspect of IBS treatment, with initial recommendations focusing on adopting a healthy eating pattern and lifestyle. This comprehensive review aims to synthesise the current literature on the impact of diet on IBS, exploringvarious dietary approaches to managing IBS, including the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet, gluten-free diet, Mediterranean diet, and tritordeum-based diet. It presents evidence from both experimental and observational studies and summarises the underlying dietary triggers in IBS, including gut microbiota dysbiosis, visceral hypersensitivity, and immune activation. In addition, it explores the efficacy and limitations of the key diet and lifestyle recommendations provided by dietary guidelines and scientific literature, highlighting the importance of individualised dietary strategies tailored to the unique needs of different types of IBS patients. By elucidating the complex interplay between diet and IBS pathophysiology, this review provides valuable insights into optimising dietary management approaches for improving symptom control and enhancing the quality of life for individuals with IBS.

A309 THE DESCRIPTION OF NUTRITION COUNSELLING FOR IRRITABLE BOWEL SYNDROME IN THE LITERATURE IS CURRENTLY LACKING

Abstract Background Dietary interventions are frequently recommended for the management of irritable bowel syndrome (IBS). Anecdotally, the nutrition counselling received by patients with IBS varies. In clinical practice, the optimal way to counsel these patients in regard to the application of dietary therapy remains unclear. Aims The aim of this scoping review is to summarize how the nutrition counselling component of dietary interventions for IBS is currently described in the literature. Methods A search of English language publications between January 1, 1994 and September 28th, 2023 was conducted using MEDLINE. Search results were limited to studies in humans and adults over age 18. The following combination of MeSH keywords was used in the search: irritable bowel syndrome AND diet food and nutrition OR counseling OR patient education OR practice guidelines OR nutrition therapy. Publications that involved providing instruction to patients to modify their diets were included. Titles and then abstracts were screened to determine if they potentially met inclusion criteria. Eligible publications were then reviewed in full. Those publications that met the inclusion criteria were included in this scoping review. Information regarding the description of nutrition counseling as a component of the dietary intervention was collected. Analysis is descriptive. Results The search strategy identified 683 potential articles. After title review, 251 abstracts were obtained and reviewed producing 31 publications that were reviewed in full. All 31 publications were included in the scoping review. Nutrition counselling was mentioned in all 31 publications, but the description of the components of nutrition counselling varied (Figure 1). No publication included all important components of nutrition counselling in the description of the dietary intervention. Conclusions Patients with IBS frequently report symptoms triggered by food. Counselling is an important component to the delivery of dietary interventions in IBS. However, the nutrition counselling components of these interventions for IBS is not well described in the literature in a reliable or standardized way. This limits the ability to provide these therapies to patients in an optimal way. Furthermore, the impact of different nutrition counselling strategies on the efficacy of dietary interventions remains unknown. Figure 1: Results of Scoping Review. Funding Agencies None

The Role of Nutraceutical Supplements in the Treatment of Irritable Bowel Syndrome: A Mini Review.

Irritable bowel syndrome (IBS) is a prolonged bowel illness that is generally stress-related and is characterized by a variety of gastrointestinal problems, the most prominent of which is chronic visceral abdominal discomfort. As a result, IBS typically impacts sufferers' standard of living, and it is typically associated with depression and anxiety symptoms. IBS medication is based mostly on symptom alleviation. However, no effective medicines have been discovered too far. As a result, it is essential to discover novel anti-IBS medications. The purpose of this brief review is to describe the existing research on nutraceutical supplements in irritable bowel syndrome management, including probiotics, prebiotics, symbiotics, herbal products, and dietary fibers. This review covered the relevant papers from the previous twenty years that were available in different journals such as Science Direct, Elsevier, NCBI, and Web of Science that were related to the role and function of nutraceuticals in Irritable Bowel Syndrome. Nutraceutical substances have a variety of modes of action, including restoring the healthy microbiome, improving the function of the gastrointestinal barrier, immunomodulatory, antiinflammatory, and antinociceptive properties. According to the literature, these substances not only can improve irritable bowel syndrome symptomatology but also have an excellent long-term safety profile. Irritable bowel syndrome is a prolonged bowel illness with a lot of gastrointestinal problems. The nutraceuticals treatment works as an anti-IBS intervention and enhances patient compliance with minimum side effects since patients take it better than pharmaceutical treatments.

Systematic Review on Herbal Preparations for Controlling Visceral Hypersensitivity in Functional Gastrointestinal Disorders.

Visceral hypersensitivity (VH) is an overreaction of the gastrointestinal (GI) tract to various stimuli and is characterized by hyperalgesia and/or allodynia. VH contributes to the etiology of many GI dysfunctions, particularly irritable bowel syndrome (IBS). Although the exact mechanisms underlying VH are yet to be found, inflammation and oxidative stress, psychosocial factors, and sensorimotor alterations may play significant roles in it. In this review, we provide an overview of VH and its pathophysiological function in GI disorders. Adverse effects of synthetic drugs may make herbal agents a good candidate for pain management. Therefore, in this review, we will discuss the efficacy of herbal agents in the management of VH with a focus on their anti-inflammatory and antioxidant potentials. Data were extracted from clinical and animal studies published in English between 2004 and June, 2020, which were collected from PubMed, Google Scholar, Scopus, and Cochrane Library. Overall, Radix, Melissia, Glycyrrhizae, Mentha, and Liquorice were the most efficient herbals for VH management in IBS and dyspepsia, predominantly through modulation of the mRNA expression of transient receptor potential vanilloid type-1 (TRPV1) and suppression of 5- hydroxytryptamine 3 (5-HT3) or the serotonin receptors. Considering the positive effects of herbal formulations in VH management, further research on novel herbal and/or herbal/chemical preparations is warranted.

Food Intolerances, Food Allergies and IBS: Lights and Shadows.

This narrative review delves into the intricate relationship between irritable bowel syndrome (IBS) and food intolerances. IBS, a chronic functional gastrointestinal disorder, is characterized by symptoms like abdominal pain and altered bowel habits. The prevalence of IBS has increased globally, especially among young adults. Food and dietary habits play a crucial role in IBS management. About 85-90% of IBS patients report symptom exacerbation linked to specific food consumption, highlighting the strong connection between food intolerances and IBS. Food intolerances often exhibit a dose-dependent pattern, posing a challenge in identifying trigger foods. This issue is further complicated by the complex nature of gastrointestinal physiology and varying food compositions. This review discusses various dietary patterns and their impact on IBS, including the low-FODMAP diet, gluten-free diet, and Mediterranean diet. It highlights the importance of a personalized approach in dietary management, considering individual symptom variability and dietary history. In conclusion, this review emphasizes the need for accurate diagnosis and holistic management of IBS, considering the complex interplay between dietary factors and gastrointestinal pathophysiology. It underlines the importance of patient education and adherence to treatment plans, acknowledging the challenges posed by the variability in dietary triggers and the psychological impact of dietary restrictions.

PMA - Zeolite (Clinoptilolite) in the Management of Irritable Bowel Syndrome - a Non-Interventional Study.

To document prospective data on tolerability and symptom frequency in the frame of a nationwide NIS, we recruited 204 IBS patients. The study focused on the IBS-related quality of life (measured by the SF-36 questionnaire) and improvements of IBS-related symptoms according to specific ROM-III criteria and stool consistency (Bristol stool scale). The participants documented their abdominal pain, bloating, number of bowel movements, and stool consistency through a web-based internet platform (initial and exit questionnaires) and daily diary entries over the period of intake (8 weeks). A total of 82.2% of the recruited patients had filled in the questionnaires before and after the 8-week treatment with PMA-zeolite. Seven of the eight subscales of the SF-36 improved significantly (p<0,001); the reduction in abdominal pain was especially significant (p<0,001). The diary entries confirmed the reduction in abdominal pain and revealed a significant reduction in days with bloating (p<0,001). The Bristol-stool-scale analysis showed improvements; particularly, patients with IBS-D benefited from the treatment (p<0,001). The treatment duration of 8 weeks was well tolerated by most patients. Under everyday life conditions, PMA-zeolite alleviated the global IBS-related symptoms and raised the quality of life (QOL). The PMA-zeolite, thus, may represent a good adjuvant therapeutic option for patients with irritable bowel syndrome.

The Role of Guar Fiber in Improving the Management of Irritable Bowel Syndrome, Functional Constipation, and Functional Diarrhea

Background and Aims Guar fiber is a soluble fiber that has been used for symptom management of irritable bowel syndrome (IBS), functional constipation (FC), and functional diarrhea (FD). However, the effect of guar fiber supplementation on symptom management is currently unclear. The aim of this review is to determine the effect of guar fiber supplementation compared with any other nutrition intervention on gastrointestinal (GI) symptoms with individuals diagnosed with IBS, FC, and FD. A secondary aim is to determine the dosage of guar fiber supplementation required to elicit an improvement in associated symptoms. Methods A systematic review (CRD42022374730) was performed with literature from inception. PubMed, EMBASE, CINAHL, and Web of Science were searched on October 28, 2022, to identify eligible studies which reported guar fiber supplementation in patients diagnosed with IBS, FC, and/or FD using the Rome criterion. Findings were synthesized narratively. Study quality was assessed using the Johanna Briggs Institute quality assessment tools. Results Nine articles reported on stool consistency, defecation frequency, laxative use, bloating, abdominal pain, flatulence, and quality of life (QOL). All pre-post studies (n = 5) reported statistically significant improvements for GI symptoms and QOL. Two of 4 randomized controlled trial studies reported improvements in GI symptoms when supplemented daily with 5 to 6 g of guar fiber for 4 to 12 weeks. Conclusions Our study shows that guar fiber supplementation appears effective in improving symptom management of IBS and FC with a 5-g/d dosage most used. Future studies are required to more clearly understand the benefits of guar fiber supplementation and elucidate dosing strategies. This review provides the grounds for further well-designed studies to investigate the impact of guar fiber supplementation in populations with IBS, FC, and FD.

Yoga and Naturopathy intervention on psychological comorbidities and autonomic function for irritable bowel syndrome patient: A case study

Irritable bowel syndrome (IBS) is a common functional disorder of the gut-brain axis, characterized by abdominal pain and altered bowel habits. A 38-year-old male patient with a sedentary lifestyle, diagnosed with IBS based on Rome IV criteria, was underwent Yoga and Naturopathy interventions for one month in our outpatient department. The result showed a reduced Irritable Bowel Syndrome Severity Score (IBS-SSS) (315 to 109) and perceived stress (PSS) score (29 to 12) level. Heart rate variability (HRV) analysis showed increased SDNN (35.4 to 48.3 ms) and RMSSD (41.3 to 58.3 ms) values, indicative of improved HRV. Notably, parasympathetic dominance was observed, evidenced by increased pNN50% (14.56 to 18.41) and H.F (41.92 to 59.63 n.u) values, while the LF/HF ratio (1.381 to 0.675) decreased. This case report suggests that lifestyle change through Yoga and Naturopathic intervention is useful in the management of IBS with psychological co-morbidities .

Role of Homoeopathy in Treatment of Irritable Bowel Syndrome - A Case Report

Irritable Bowel Syndrome (IBS) is a recurrent chronic disorder of gasterointestinal system affecting 10-30% of total worldwide population. Women are more affected than men. Homoeopathy is one of the system of medicine which acts on psychosomatic plane of an individual which can bring IBS to complete cure. Homeopathy is the choice of treatment for all psychosomatic disorders especially for IBS. Management of IBS should concentrate on psychological and behavioral interventions along with proper medication. Reducing mental stress, regular exercises, yoga and meditation will give more beneficial in reducing the severity of IBS.

The Role of Guar Fibre in Improving the Management of Irritable Bowel Syndrome, Functional Constipation and Functional Diarrhea: A Systematic Review

The Role of Guar Fibre in Improving the Management of Irritable Bowel Syndrome, Functional Constipation and Functional Diarrhea: A Systematic Review

COLPLATIR® as a Novel Therapeutic Adjuvant for the Management of Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a chronic disorder of the gastrointestinal system characterized by abdominal pain or discomfort and associated with different comorbidities like fibromyalgia, chronic pelvic pain, gastroesophageal reflux disease, anxiety and depression. In this study, the effects of COLPLATIR®, a nutraceutical product with a patented technology named BUTIRESOLV®, were investigated. In vivo and Ex-vivo analysis were carried out on IBS with diarrhoea (IBS-D) mouse model by intracolonic administration of Oil of Mustard (OM). Positive results have been obtained, thus demonstrating that the nutraceutical COLPLATIR® could reduce the abnormalities in intestinal motility, as observed in IBS.

Osteopathic Manipulative Treatment for the Management of Irritable Bowel Syndrome: A Case Report

Abstract Irritable bowel syndrome (IBS) is one of the most common disorders of the gastrointestinal system, occurring in 10-20% of the general population.1,2,3 IBS is associated with heavy social and economic costs in the United States, as it results in the second highest cause of work absenteeism and accounts for 25-50% percent of all gastroenterology referrals.1,4 IBS is characterized by recurrent abdominal pain or discomfort and bowel dysfunction as diarrhea, constipation or both, in the absence of any organic cause.3,5,6,7 The pathophysiology of IBS appears multifactorial, although current focus for an understanding of the disease process is on alteration of gastrointestinal motility, visceral hypersensitivity and dysregulation of the brain-gut axis between the autonomic nervous system (ANS) and the enteric nervous system (ENS).6,8 The lack of full understanding of the pathophysiologic processes of IBS means current management options are often ineffective and unreliable, leaving patients with frustrating and sometimes disabling symptoms.2,7 An osteopathic approach using osteopathic manipulative treatment (OMT) to address symptoms related to IBS is an under-explored treatment option. The use of OMT within a treatment plan offers the ability to address manifestations of visceral and somatic dysfunctions unique to each patient. This case report outlines a successful osteopathic manipulative treatment course for a patient suffering from IBS symptoms. Randomized controlled trials (RCTs) for the use of OMT on patients with IBS in the current literature are also reviewed below and provide further preliminary evidence that OMT may be effective in managing IBS symptoms.2,5,7,9,11