Efficacy of a self-management program using an eHealth system to reduce symptom severity in patients with irritable bowel syndrome simultaneously with changes in gut microbiota: a randomized controlled trial

Abstract

ABSTRACTObjectiveThis study aimed to evaluate whether a self-management program using the eHealth system could reduce symptom severity in patients with irritable bowel syndrome (IBS). Impact of the intervention on quality of life and gut microbiota were also examined.DesignThis study was designed as an open label, simple randomized controlled trial comparing an intervention group that attended an eHealth self-management program and a treatment as usual group. Participants were Japanese women between the ages of 18 and 36. Forty symptomatic IBS individuals who met the inclusion criteria were recruited and randomly assigned to the two groups. The eHealth group received 8 weeks of unlimited access to the self-management program containing a wide variety of e-learning content. Participants’ severity of IBS symptoms, the main outcome, was assessed using the irritable bowel syndrome-severity index (IBS-SI) at baseline and 8 weeks. The secondary outcomes of participants’ quality of life and gut bacteria were also assessed at baseline and week 8.ResultsThere was a significant difference in the net change in IBS severity index (IBS-SI) score between the eHealth and treatment as usual group (−50.1; 95% CI, −87.6 to -12.6; p = 0.010). The eHealth group had significantly lower IBS-SI scores following 8 weeks of intervention compared with the baseline scores (t = − 3.2, p < 0.01). The implementation of the eHealth program was accompanied by improvement of quality of life and decrease of phylum-level Cyanobacteria occupancy, respectively.ConclusionThe implementation of eHealth for IBS was shown to reduce IBS symptoms.Key MessagesWhat is already known on this topic –eHealth programs based on diet and probiotic use have shown good results in reducing IBS symptomsWhat this study adds– a self-management program with an e-learning component based on a successful self-help guidebook for IBSHow this study might affect research, practice or policy– The proposed eHealth model reduces symptoms and improves the quality of life of IBS patients, providing an efficient and cost-effective intervention option to be adopted in policy and practice, and creates scope for future research in food intake, exercise, and sleep management through eHealth for IBS.