Expert from global health system cites new research suggesting five lifestyle modifications could be used as a primary prevention strategy for the common gastrointestinal disease

April 18, 2024, Cleveland: There are several lifestyle choices that can greatly reduce an individual's risk of developing irritable bowel syndrome (IBS), and these healthy habits can also form part of a holistic approach to managing existing cases of IBS, according to an expert from global health system Cleveland Clinic, speaking ahead of World IBS Awareness Day on 19 April.

IBS is a common but uncomfortable gastrointestinal disease, characterized by abdominal pain, bloating, and abnormal bowel habits.  The International Foundation for Gastrointestinal Disorders estimates that 5-10% of the world's population has IBS. According to the foundation, women have the condition more often than men, most sufferers are under the age of 50, and many people are diagnosed only years after their symptoms began.

'The causes of IBS are not clear and risk factors identified by researchers include altered gut bacteria, severe infections of the GI tract, food intolerances, childhood stress, and problems with how the mind and gut coordinate,' says Dr. Anthony Lembo, Director of Research at Cleveland Clinic's Digestive Disease Institute. 'Recent research, however, indicates that certain lifestyle modifications can significantly reduce an individual's risk of developing IBS.'

Dr. Lembo cites a study, in which he was not involved, published earlier this year in the British gastroenterology journal, Gut. The study followed a group of 64,268 U.K.-based adults for an average of 12.6 years. Participants' ages ranged from 37 to 73 (average age of 55), and none had a previous IBS diagnosis.

'The study in Gut found five lifestyle habits that could significantly reduce an individual's risk of developing IBS, suggesting that lifestyle modifications can be used as a primary prevention strategy. These habits are beneficial to health in general, and individuals who follow three to five of the lifestyle recommendations reduced their risk of developing IBS by 42%.'

The five lifestyle factors identified are: getting optimal sleep (seven to nine hours); participating in regular vigorous physical activity; following a high-quality, balanced diet; never smoking; and limiting alcohol intake.

Commenting on how these lifestyle habits can be implemented in practice, Dr. Lembo suggests individuals improve their quality of sleep by following sleep hygiene principles such as limiting screen time before bed, creating a nighttime routine and avoiding caffeinated beverages in the evening. To ensure a quality diet, an eating plan such as the Mediterranean Diet is beneficial as it includes plenty of fiber and focuses on unprocessed foods. As for exercise, depending on individuals' health and with a doctor's approval, doing 30 minutes of moderate to vigorous exercise three to five times a week should be helpful.

Managing IBS

For individuals who have already developed IBS, the same lifestyle factors have been shown to help manage the condition, and the recommendations are included in many international guidelines as a first-line treatment, Dr. Lembo says.

In addition, individuals can work with their healthcare team to identify and address individual triggers for IBS attacks, which could be anything from stress to a particular medication or food types. In the case of food, elimination diets, undertaken in consultation with a doctor, can help ease discomfort and identify which foods trigger an IBS attack. Foods typically eliminated include gluten, dairy, sugar and packaged and processed foods.

However, lifestyle changes and avoiding triggers are not enough for many patients, Dr. Lembo says. 'At centers such as Cleveland Clinic the focus is on comprehensive multidisciplinary care. There are many medication options available to treat specific IBS symptoms and underlying conditions, and behavioral therapies could also be useful.'

Dr. Lembo concludes, 'World IBS Day provides an excellent opportunity to encourage people not to suffer gastrointestinal symptoms in silence. It is not a good idea to self-diagnose and self-medicate as many IBS symptoms are also common in other digestive diseases, some of which are serious. An IBS diagnosis and treatment plan can greatly improve a person's quality of life, and in the unlikely event that a more serious illness is diagnosed, this can be treated sooner, thereby improving outcomes.'