Alex Gazzola and Julie Thompson RD are guest-blogging for us during IBS Awareness Month! The co-authors of IBS: Dietary Advice to Calm Your Gut will be writing each week with tips and advice for management of IBS.
IBS Part Four: The Future of IBS
We have looked at the diagnosis of IBS, its treatment, and touched upon dietary interventions in the previous three posts. In this final post during IBS Awareness Month, we look at what’s in store in the future of IBS.
Interestingly, we are seeing lots of new research – which the dedicated charity the IBS Network updates its members on, via its magazine Gut Reaction – and IBS feels less of a ‘Cinderella’ condition than it did before. We have a way to go before it is less stigmatised and marginalised, but can be confident that improvements in treatments will come.
Testing for IBS after gastrointestinal infection
A new test was developed in the United States in 2015.
Called IBSchek, it looks for antibodies to both CdtB – a toxin produced by gastroenteritis-causing bacteria – and vinculin – a protein which lines the gut. Antibodies to CdtB also react with vinculin, which, it is proposed, causes damage to the gut lining, leading to the key symptoms of IBS.
Researchers have found the test distinguishes patients with IBS from those with inflammatory bowel disorders, thereby helping to confirm diagnosis.
This test is only available privately in the UK at present and would likely need approval from health bodies ahead of future use within the NHS.
Faecal Microbiota Transplantation (FMT)
This is the transplantation of a sample of stool from a healthy individual into the bowel of a patient with digestive complaints for therapeutic purposes. It is commonly termed a poo transplant!
FMT is not a new idea. It has been used for such conditions as resistant infections of clostridium difficile – a particularly nasty bacterial pathogen – for which it has impressive (90%) effectiveness.
Now, it is also being researched in other digestive conditions where a disordered microbiome is possibly involved – such as IBS.
Should this treatment become available, it must only be considered through the NHS, for which it will have been carefully vetted and approved. There is some private availability and ‘home treatment’ recommendations online, but this is categorically not something to self-administer or undergo without strict protocols having been followed.
Much more research is needed, but it is promising.
People with IBS and non-coeliac gluten sensitivity have higher levels of a protein called zonulin in the gut.
There is a theory that pathogenic microbes can trigger the release of zonulin. The protein regulates the tight junctions between the cells lining the digestive tract. Increased zonulin means the tight junctions are ‘loosened’, potentially allowing larger protein molecules into the body – this is sometimes dubbed ‘leaky gut’. It is speculated that this can trigger inflammation and immune system responses.
More research is needed, but drugs to control the production of zonulin may offer future potential to treat the gut lining and improve tolerance to food
Microbiota Profile Testing
Not yet available, but showing a lot of promise.
This would involve analysing individuals’ gut bacteria, to determine which may and may not benefit more from a low-FODMAP diet, and help better targeting of diet treatment.
More low-FODMAP Foods
A number of dedicated low-FODMAP brands are now offering products suitable for those restricting FODMAPs. These include Bay’s Kitchen (sauces), Casa de Sante (seasonings, granolas, dressings), FODY Foods (salsas, sauces, oils, snack bars) and many more. There’s even a recently launched online store in the UK – called FODMarket – catering to the demand. Expect many more launches in future …
If you wish to know more about IBS, you can purchase IBS: Dietary Advice to Calm Your Gut, from the Sheldon Press Bookshop.
Alex Gazzola is a journalist and author who has been specialising in gut health and food sensitivities for over a decade. He writes widely for the national and international press, and is author of several books, including Coeliac Disease: What you need to know, and Living with Food Intolerance, both for Sheldon Press. Julie Thompson is a registered dietitian with a specialism in inflammatory and functional gut disorders and ‘free from’ diets for food intolerances and allergies. She is an adviser to the IBS Network and runs the Calm Gut Clinic.