Vitamin D3 as a novel treatment for irritable bowel syndrome: single case leads to critical analysis of patient-centred data

Objectives: This study aimed to evaluate whether vitamin D deficiency is associated with the severity of symptoms of irritable bowel syndrome (IBS) patients. Stress and gut inflammation can increase the serum level of corticotropin-releasing hormone (CRH) and interleukin-6 (IL-6), leading to a change in bowel movements. The aim of this study was to evaluate the anti-inflammatory and psychological effects of vitamin D3 supplementation on the symptom improvement of patients with a diarrhea-predominant form of IBS (IBS-D). Methods: Eighty-eight IBS-D patients (age: 18–65 years) based on Rome IV criteria who suffered from vitamin D deficiency and/or insufficiency were enrolled in this randomized, placebo-controlled trial from February 2017 to May 2018 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were randomly divided into two groups. The intervention group received 50,000 IU vitamin D3 weekly and the control group received a placebo for 9 weeks. All patients received Mebeverine 135 mg twice a day besides supplementation. The IBS Severity Score System (IBS-SSS), serum 25(OH) vitamin D3, CRH, and IL-6 were measured before and after interventions. Results: Seventy-four patients completed the study. The severity of IBS symptoms (p < 0.01) and IL-6 (p = 0.02) decreased significantly in the intervention group as compared to the control group, but there was no significant difference in the serum level of CRH. Also, in the treatment group, IBS-SSS and IL-6 were significantly reduced at the end of the study from baseline (p < 0.01 and p < 0.03, respectively). Conclusion: Our findings indicate that vitamin D3 supplementation can modulate the serum level of CRH and IL-6 and can improve symptoms in IBS-D patients. Vitamin D3 supplementation should be considered in IBS-D patients who suffer from vitamin D deficiency and/or insufficiency.

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Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects

Cognitive Behaviour Therapy ◽

10.1080/16506073.2016.1194455 ◽

2016 ◽

Vol 45 (6) ◽

pp. 415-430 ◽

Cited By ~ 7

Author(s):

Katja Boersma ◽

Brjánn Ljótsson ◽

Hanna Edebol-Carlman ◽

Martien Schrooten ◽

Steven J. Linton ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Experimental Design ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Single Case ◽

Cognitive Behavioral ◽

Irritable Bowel

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Rome criteria IV – irritable bowel syndrome (2016): what's new?

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2017-95-11-987-993 ◽

2018 ◽

Vol 95 (11) ◽

pp. 987-993

Author(s):

A. A. Svistunov ◽

Michael A. Osadchuk ◽

A. M. Osadchuk ◽

L. I. Butorova

Keyword(s):

Irritable Bowel Syndrome ◽

Evidence Based Medicine ◽

Critical Analysis ◽

Diagnosis And Treatment ◽

Comparative Characteristic ◽

Evidence Based ◽

Rome Criteria ◽

Irritable Bowel ◽

Based Medicine

The report provides a critical analysis of the provisions of the Rome Consensus IV, related to irritable bowel syndrome. The comparative characteristic differences between the Roman criteria I, II, III and IV, relating to basic requirements for the diagnosis and treatment of this disease and try to bring them into the process of evolution to the basic requirements of evidence-based medicine.

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Pain and psyche in a patient with irritable bowel syndrome: chicken or egg? A time series case report

BMC Gastroenterology ◽

10.1186/s12876-021-01879-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Felicitas Engel ◽

Tatjana Stadnitski ◽

Esther Stroe-Kunold ◽

Sabrina Berens ◽

Rainer Schaefert ◽

...

Keyword(s):

Time Series ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Case Report ◽

Single Case ◽

Somatic Symptoms ◽

Single Case Study ◽

Psychological Variables ◽

Irritable Bowel

Abstract Background Irritable bowel syndrome (IBS) appears to have a bidirectional interaction with both depressive and anxiety-related complaints. However, it remains unclear how exactly the psychological complaints, at the individual level, are related to somatic symptoms on a daily basis. This single case study investigates how somatic and psychological variables are temporally related in a patient with irritable bowel syndrome. Case report The patient was a woman in her mid-twenties with an IBS diagnosis. She reported frequent soft bowel movements (5–6 times per day), as well as flatulence and abdominal pain. She resembled a typical IBS patient; however, a marked feature of the patient was her high motivation for psychosomatic treatment as well as her willingness to try new strategies regarding the management of her symptoms. As an innovative approach this single case study used a longitudinal, observational, time series design. The patient answered questions regarding somatic and psychological variables daily over a period of twelve weeks with an online diary. The diary data was analysed using an autoregressive (VAR) modeling approach. Time series analyses showed that in most variables, strong same-day correlations between somatic (abdominal pain, daily impairment) and psychological time series (including coping strategies) were present. The day-lagged relationships indicated that higher values in abdominal pain on one day were predictive of higher values in the psychological variables on the following day (e.g. nervousness, tension, catastrophizing, hopelessness). The use of positive thinking as a coping strategy was helpful in reducing the pain on the following days. Conclusion In the presented case we found a high correlation between variables, with somatic symptoms temporally preceding psychological variables. In addition, for this patient, the use of positive thoughts as a coping strategy was helpful in reducing pain.

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