Key Breakthroughs from IBS Days 2024 – A New Era in Understanding and Treating IBS
Irritable Bowel Syndrome (IBS) is a complex disorder influenced by various factors. Recent research presented at IBS Days 2024 has provided valuable insights into the pathophysiology of IBS, shedding light on the gut microbiome, immune activation, intestinal permeability, and the microbiota-gut-brain axis, along with the impact of sex and gender. Here are the most important takeaways:
1. Sex and Gender Differences in IBS
Dr. Susanna Walter emphasized that women are more sensitive to IBS-related pain. This is attributed to differences in the microbiota-gut-brain axis, colonic mast cell function, autonomic nervous system, and serotonin levels. Recognizing these gender-specific differences is essential for creating personalized treatment plans for men and women with IBS.
2. Eosinophil Activity and IBS Severity
Dr. Maria Vicario presented groundbreaking findings on eosinophils—immune cells that can become activated in the small intestine and colon, contributing to IBS symptoms, particularly in IBS-D. Vicario's research showed that increased eosinophil activity is correlated with clinical severity, highlighting the need to keep their activity in balance for healthy gastrointestinal function.
In the Gut Revival program we measure eosinophil activity in the blood, not in the gut. To measure this activity you would need to take a sample of the gut lining during a colonoscopy. As technology improves, we may be able to access this via a stool sample. Hopefully, we can add this test in the future.
4. Gut-Brain Communication
Dr. Premysl Bercik introduced new findings on how gut bacteria communicate with the brain, influencing neuro-immune genes and central neural plasticity. These interactions can explain why patients with infectious gastroenteritis or severe stress develop psychiatric comorbidities like anxiety and depression alongside IBS.
In our programs, we always utilize stool testing to understand the composition of the microbiome. Our big focus is to remove burden on the gut and restore bacterial resiliency.
5. Mast Cells and Pain Perception in IBS
Chronic pain in IBS is often triggered by mast cell activation. Dr. Guy Boeckxstaens reviewed how this immune response—caused by food, psychological stress, or infections—leads to abnormal pain perception. He also introduced Ebastine, an antihistamine, as a potential treatment for non-constipated IBS patients, showing promise in alleviating chronic abdominal pain.
Often times we add histamine tests to our custom blood panels in the Gut Revival program and are looking at patterns in the gut microbiome via stool test to assess high levels of histamine producing bacteria. We also always run a food sensitivty panel to understand which foods are creating an immune response.
6. IBS Mimickers and Overlapping Conditions
A major focus was on identifying conditions that mimic or co-occur with IBS. Drs. Lin Chang and Giovanni Barbara discussed six commonly misdiagnosed disorders, including celiac disease, microscopic colitis, and post-COVID-19 IBS. Distinguishing these conditions is essential to ensure appropriate management and treatment.
A stool test can be a great way to assess long-haul COVID patterns, potential patterns of celiac along with a Tissue Transglutaminase IgA antibody (tTG-IgA) blood test and measuring calprotectin and fecal occult blood give insights into colitis.
7. Bile Acid Diarrhea and IBS-D
Dr. Michael Camilleri highlighted the underrecognized disorder of bile acid malabsorption, which often affects IBS-D patients. Bile acid sequestrants are the first-line treatment, with emerging therapies like liraglutide showing effectiveness in reducing stool frequency in severe cases.
Bile acid is a marker we run within the Gut Revival program.
8. Holistic IBS Management
Dr. Magnus Simren stressed the importance of holistic care in managing IBS, integrating clinical, dietary, lifestyle, and psychosocial factors. Addressing mental health comorbidities such as anxiety and depression is crucial for improving both gastrointestinal and non-GI symptoms.
Our work includes somatic therapy with Kara Kihm, a licensed therapist and reiki practitioner. Her work inside our practice bridges the gap between the mind-gut connection.
9. Diet and IBS
The low-FODMAP diet, Mediterranean diet, and a new focus on low-carbohydrate diets were highlighted for their effectiveness in reducing IBS symptoms. Tailored diet interventions, especially under the guidance of a dietitian, are crucial for long-term symptom relief, particularly when managing food intolerances associated with IBS.
One of our three key tests that we always run in the Gut Revival program is a food sensitivity test so we can understand what foods are placing burden on the gut.
10. Probiotics, Prebiotics, and Microbiome-Based Therapies
Dr. Eamonn Quigley discussed the benefits of prebiotics, probiotics, and postbiotics for IBS, emphasizing their ability to modulate the gut microbiota and improve symptoms. New microbiome-based therapies, including MRx1234, offer potential in treating IBS, although further research is needed to close the gap between clinical practice and emerging science.
Our greatest work at Fearless Fig is from a life-long obsession with how the microbiome can be fed, restored and supported to create a state of resiliency. We deeply understand how to feed and nourish the microbiome and great a balanced gut state.
The Path Forward: Personalization and Holistic Care
The recurring theme of IBS Days 2024 was the need for personalized treatment approaches. From understanding the gender-based differences in symptoms to exploring microbiome-based therapies, the future of IBS treatment lies in customization. Additionally, managing mental health comorbidities, such as anxiety and depression, remains a critical aspect of care, with holistic strategies integrating psychotherapy, diet, and lifestyle adjustments showing significant promise.
Final Thoughts
As research continues to shed light on the complexities of IBS, it’s clear that conventional medicine is finally catching up to the work we have been doing inside of Fearless Fig for over a decade. It is exciting to see microbiome modulation, mental health treatments, food and supplements start to step into the spotlight for healing IBS. Our Gut Revival program has been built on the pillars of personalized treatment approaches, functional stool testing, nervous system regulation and addressing mental health concerns through somatic therapy.
If you want to dive deeper into your IBS or digestive healing journey, make sure to complete an application for our GUT REVIVAL program and make sure its right for you.