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Nutrition, Complementary and Alternative Treatments for Irritable Bowel Syndrome and Functional Constipation

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 13489

Special Issue Editors


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Guest Editor
Division of Gastroenterology, AOUI Verona, University of Verona, 37134 Verona, Italy
Interests: inflammatory bowel disease; celiac disease; short bowel syndrome; chronic pancreatitis; functional gastrointestinal disorders
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Guest Editor
Second Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
Interests: myotomy; esophagus achalasia; stomach fundoplication

Special Issue Information

Dear Colleagues,

Patients’ requests for a “holistic” treatment approach to disorders of gut–brain interaction have been steadily increasing in recent years spanning from pediatric age to geriatric population. However, this approach is often dismissed by physicians based on the perception of a lack of scientific evidence for nutrition and complementary and alternative treatment (CAM). CAM is broadly defined as medical practices neither taught widely in medical schools nor generally available in public hospitals. Regardless of the therapies employed, the CAM modality is intended to restore balance and to facilitate the body’s own healing responses, thereby ameliorating troublesome symptoms. The available literature on nutrition and CAM has been historically biased by a limited research approach in terms of sample size, randomization, outcome parameters and statistical evaluation. Several randomized, controlled trials (RCTs) have recently provided sound evidence of diet advice and CAM effectiveness in disorders of gut–brain interaction both in adults and children. Irritable bowel syndrome (IBS) is a challenging disorder that requires a multi-targeted approach for best clinical practice. Moreover, functional constipation (FC) has been repeatedly shown to often evolve into irritable bowel syndrome over the natural course of the disease. I believe it is time to approach nutrition and CAM for IBS and FC with an open mind, in order to welcome with scientific rigor our disabled patients’ requests. This Special Issue will be devoted to promoting our understanding of nutrition and CAM treatments for irritable bowel syndrome and functional constipation. In light of this, our interest must be limited to the Journal's audience. Therefore, the focus of this issue will be on diet advice, herbal remedies, probiotics and “old mama recipes” for a healthy bowel that are addressed in RCTs or quasi-RCTs for IBS and FC. Review articles, metanalysis and cutting-edge open label trials will be considered for publication as well. I believe the new information provided will stimulate innovative clinical interest in the unmet need to improve the management of irritable bowel syndrome.

Dr. Giuseppe Chiarioni
Dr. Teodora Surdea-Blaga
Guest Editors

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Keywords

  • irritable bowel syndrome
  • constipation
  • diarrhea
  • probiotics
  • herbal remedies
  • supplements
  • kiwifruit
  • prunes
  • fibers
  • healthy food
  • nutrition
  • diet advice

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Published Papers (3 papers)

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Review

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25 pages, 1712 KiB  
Review
The Role of the FODMAP Diet in IBS
by Luisa Bertin, Miriana Zanconato, Martina Crepaldi, Giovanni Marasco, Cesare Cremon, Giovanni Barbara, Brigida Barberio, Fabiana Zingone and Edoardo Vincenzo Savarino
Nutrients 2024, 16(3), 370; https://doi.org/10.3390/nu16030370 - 26 Jan 2024
Cited by 10 | Viewed by 8517
Abstract
The low FODMAP (fermentable oligosaccharide, disaccharide, monosaccharide, and polyol) diet is a beneficial therapeutic approach for patients with irritable bowel syndrome (IBS). However, how the low FODMAP diet works is still not completely understood. These mechanisms encompass not only traditionally known factors such [...] Read more.
The low FODMAP (fermentable oligosaccharide, disaccharide, monosaccharide, and polyol) diet is a beneficial therapeutic approach for patients with irritable bowel syndrome (IBS). However, how the low FODMAP diet works is still not completely understood. These mechanisms encompass not only traditionally known factors such as luminal distension induced by gas and water but also recent evidence on the role of FOMAPs in the modulation of visceral hypersensitivity, increases in intestinal permeability, the induction of microbiota changes, and the production of short-chain fatty acids (SCFAs), as well as metabolomics and alterations in motility. Although most of the supporting evidence is of low quality, recent trials have confirmed its effectiveness, even though the majority of the evidence pertains only to the restriction phase and its effectiveness in relieving abdominal bloating and pain. This review examines potential pathophysiological mechanisms and provides an overview of the existing evidence on the effectiveness of the low FODMAP diet across various IBS subtypes. Key considerations for its use include the challenges and disadvantages associated with its practical implementation, including the need for professional guidance, variations in individual responses, concerns related to microbiota, nutritional deficiencies, the development of constipation, the necessity of excluding an eating disorder before commencing the diet, and the scarcity of long-term data. Despite its recognized efficacy in symptom management, acknowledging these limitations becomes imperative for a nuanced comprehension of the role of a low FODMAP diet in managing IBS. By investigating its potential mechanisms and evidence across IBS subtypes and addressing emerging modulations alongside limitations, this review aims to serve as a valuable resource for healthcare practitioners, researchers, and patients navigating the intricate landscape of IBS. Full article
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11 pages, 298 KiB  
Review
The Use of Fibers, Herbal Medicines and Spices in Children with Irritable Bowel Syndrome: A Narrative Review
by Daniela Pop, Radu Samuel Pop and Dorin Farcău
Nutrients 2023, 15(20), 4351; https://doi.org/10.3390/nu15204351 - 12 Oct 2023
Cited by 1 | Viewed by 1984
Abstract
The pathophysiology of irritable bowel syndrome in children involves multiple factors. Thus, treatment options are variable, targeting both diet and the child’s and parents’ behavior via pharmacological and psychological interventions or neuromodulation. Parents are increasingly interested in complementary and alternative therapies for children [...] Read more.
The pathophysiology of irritable bowel syndrome in children involves multiple factors. Thus, treatment options are variable, targeting both diet and the child’s and parents’ behavior via pharmacological and psychological interventions or neuromodulation. Parents are increasingly interested in complementary and alternative therapies for children with irritable bowel syndrome, especially when other treatments have been tried without relieving the child’s symptoms. This paper examines current evidence for the benefits and side effects of herbal remedies and spices in pediatric patients with IBS. The benefits of peppermint oil, STW5, psyllium fiber, Curcuma, ginger, and other herbal medicines are discussed based on findings in the current literature. Full article

Other

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16 pages, 470 KiB  
Systematic Review
The Effect of Polyphenols, Minerals, Fibers, and Fruits on Irritable Bowel Syndrome: A Systematic Review
by Giuseppe Chiarioni, Stefan Lucian Popa, Abdulrahman Ismaiel, Cristina Pop, Dinu Iuliu Dumitrascu, Vlad Dumitru Brata, Traian Adrian Duse, Victor Incze and Teodora Surdea-Blaga
Nutrients 2023, 15(18), 4070; https://doi.org/10.3390/nu15184070 - 20 Sep 2023
Cited by 4 | Viewed by 2544
Abstract
Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. Various dietary factors have been implicated in the pathogenesis and management of IBS symptoms. This systematic review aims to evaluate the effects of [...] Read more.
Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. Various dietary factors have been implicated in the pathogenesis and management of IBS symptoms. This systematic review aims to evaluate the effects of polyphenols, minerals, fibers, and fruits on the symptoms and overall well-being of individuals with IBS. Materials and Methods: A comprehensive literature search was conducted in several electronic databases, including PubMed, Scopus, and Web of Science. Studies published up until July 2023 were included. Results: The selected studies varied in terms of study design, participant characteristics, intervention duration, and outcome measures. Overall, the findings suggest that dietary interventions involving polyphenols, minerals, fibers, and fruits can have a positive impact on IBS symptoms. Dietary fiber supplementation, particularly soluble fiber, has been associated with reduced bloating and enhanced stool consistency. Conclusions: This systematic review provides evidence supporting the beneficial effects of polyphenols, minerals, fibers, and fruits in IBS patients. These dietary components hold promise as complementary approaches for managing IBS symptoms. However, due to the heterogeneity of the included studies and the limited number of high-quality randomized controlled trials, further well-designed trials are warranted to establish the optimal dosages, duration, and long-term effects of these interventions. Understanding the role of specific dietary components in IBS management may pave the way for personalized dietary recommendations and improve the quality of life for individuals suffering from this complex disorder. Full article
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