IBS study investigates ‘what works for whom, and how’

In a world-first, a clinical trial will compare the effectiveness of two irritable bowel syndrome (IBS) treatments in a bid to help clinicians better match the right treatment to the right patient.
 
The University of Melbourne’s randomised controlled trial will compare a low FODMAP diet and exposure-based cognitive behavioural therapy (CBT) to determine why some patients respond better to one treatment over the other.
 
It comes after a previous six-month trial found that while the low FODMAP diet helps most patients, around 21% had little to no benefit.
 
With many patients currently cycling through medications, dietary changes, tests, emergency visits, and invasive procedures throughout their IBS treatment, the goal of the new trial is to help patients get the appropriate treatment sooner.
 
Associate Professor Jessica Biesiekierski, who is Head of the Human Nutrition Group at The University of Melbourne, told newsGP this research is ‘so relevant for GPs’ as the first port of call for many patients with IBS.
 
‘The main aim is to look at which treatment works for whom and why, and throughout that 12-week program, we’re collecting symptom data to understand how these treatments work,’ she said.
 
‘GPs manage the majority of IBS cases, and they’re expected to address IBS which is a complex multisystem disorder with overlapping psychological, physiological, and dietary drivers.
 
‘They then obviously have limited time and resources to manage that within their consult, so hopefully this trial can help that.’
 
Currently, around 20% of Australians experience IBS symptoms, with women three times more likely to experience them than men.
 
As part of the new study, participants will be randomly assigned to receive either the low FODMAP diet or CBT and will undergo 12 weeks of treatment.
 
This will also include regular one-on-one sessions with a dietician or psychologist to monitor their progress, and participants will have follow-up appointments at the three-month and six-month marks to see whether their symptom benefits have remained.
 
Associate Professor Biesiekierski said while there is much evidence about how these treatments can help to improve IBS symptoms, they do not work for everyone.
 
‘What we’re hoping is that we can then be able to provide an understanding of, when a patient does present to the GP, what treatment or what elements of treatment really early on are best for the patient,’ she said.
 
‘Many of these IBS patients will go through a lifelong journey of trial and error trying to find which treatment works best for them, and for some people also trying to find a diagnosis if they haven’t gone to the GP straight away.
 
‘So, we’re trying to work that out and make sure that people can get the right treatment from the start.’
 
The research team is recruiting 200 people across Australia and the United States to take part in the free trial, which will be conducted remotely.
 
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FODMAP IBS irritable bowel syndrome