Cited by 154Gastrointestinal motility and disordersInfant Health and DevelopmentGut microbiota and health

Behavioral and Diet Therapies in Integrated Care for Patients With Irritable Bowel Syndrome

Chey, William D., Keefer, Laurie, Whelan, Kevin, Gibson, Peter R.·2021·Gastroenterology

Abstract

Irritable bowel syndrome (IBS) is a common, symptom-based condition that has negative effects on quality of life and costs health care systems billions of dollars each year. Until recently, management of IBS has focused on over-the-counter and prescription medications that reduce symptoms in fewer than one-half of patients. Patients have increasingly sought natural solutions for their IBS symptoms. However, behavioral techniques and dietary modifications can be effective in treatment of IBS. Behavioral interventions include gastrointestinal-focused cognitive behavioral therapy and gut-directed hypnotherapy to modify interactions between the gut and the brain. In this pathway, benign sensations from the gut induce maladaptive cognitive or affective processes that amplify symptom perception. Symptoms occur in response to cognitive and affective factors that trigger fear of symptoms or lack of acceptance of disease, or from stressors in the external environment. Among the many dietary interventions used to treat patients with IBS, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols is the most commonly recommended by health care providers and has the most evidence for efficacy. Patient with IBS who choose to follow a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols should be aware of its 3 phases: restriction, reintroduction, and personalization. Management of IBS should include an integrated care model in which behavioral interventions, dietary modification, and medications are considered as equal partners. This approach offers the greatest likelihood for success in management of patients with IBS.

Integrity signals

Registry

Crossref · 10.1053/j.gastro.2020.06.099

Cites

141 of 141 references verified0 citation errors · 0 not checkable

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  • Integrated care of patients with irritable bowel syndrome and other DGBI has been shown to improve health-related quality of life, patient psychological wellbeing and other outcomes.

    “While evidence for timely, collaborative care is limited in the HSD/hEDS population, integrated care of patients with irritable bowel syndrome and other DGBI have been shown to improve health‐related quality of life, patient psychological wellbeing and other outcomes. 84 , 85”

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Authors
Chey, W. D., Keefer, L., Whelan, K., & Gibson, P. R.
Affiliations
  • University of Michigan (US)
  • King's College London (GB)
  • Monash University (AU)
Corresponding author
Chey, William D.
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2021-01
Volume
160
Issue
1
Pages
47-62
ISSN
0016-5085 (ISSN-L)
OpenAlex
W3093338182
Cited by
154
References
142
Citations by year
2026: 29 · 2025: 21 · 2024: 22 · 2023: 20 · 2022: 35 · 2021: 25 · 2020: 1 · 2013: 1
FWCI
3.52
Type
journal article
Language
en
Open access
closed
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Almond Board of California
  • Meso Scale Diagnostics
  • International Nut and Dried Fruit Council
  • Takeda Pharmaceuticals U.S.A.
  • Pfizer
  • Allergan
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
irritable bowel syndrome, behavior therapy, dietary therapy, gut-directed hypnotherapy, cognitive behavioral therapy, FODMAP diet, integrated care, symptom perception, stress, personalized nutrition
MeSH terms
Behavior Therapy, Humans, Delivery of Health Care, Integrated, Irritable Bowel Syndrome

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