Personalised Multidisciplinary Treatment in Moderate to Severe IBS

Personalised Multidisciplinary Multimodal Treatment in IBS

This is a 12-month longitudinal intervention study in adults (18-65 years) with moderate-severe IBS (IBS-SSS ≥175) evaluating a personalized, patient-centered multidisciplinary treatment delivered in a Swedish tertiary care setting. The program includes an internet-based IBS school followed by four evidence-based modules (physician-led medical management/education, dietician-led dietary intervention, psychologist-led IBS-focused behavioral therapy, and physiotherapy) delivered in a sequence chosen by the participant, with symptom evaluation after each module. Outcomes are assessed before and after treatment, with the primary endpoint defined as treatment response (IBS-SSS reduction ≥50 points), and secondary endpoints covering symptom/psychological measures, visceral sensitivity and biological stress plus gut biomarkers, and multimodal brain imaging (structural MRI, rs-fMRI, task fMRI, and insula MRS).

Inclusion Criteria:

• IBS diagnosis confirmed according to the Rome IV criteria
• Moderate-to-severe symptoms based on the IBS Symptom Severity Score (IBS-SSS)
• Age 18-65 years
• Written informed consent.

Exclusion Criteria:

• Contraindications to MRI, e.g., claustrophobia, pregnancy, or metallic implants.
• History of major gastrointestinal surgery, e.g., appendectomy.
• Severe psychiatric illness, such as bipolar disorder or schizophrenia.
• Insufficient Swedish language knowledge to complete the questionnaires