In everyday practice, a large proportion of patients with gut complaints do not fit the tidy diagnostic box of irritable bowel syndrome. They present with abdominal pain, bloating or altered bowel habits; a history of gastrointestinal infection or antibiotic use; or evidence of a compromised intestinal barrier yet fall short of, or sit alongside, a formal IBS diagnosis. For these patients, a symptom label is rarely enough to guide treatment.
What is actually driving their symptoms, and how should we intervene?
This presentation looks beyond the IBS label at three overlapping domains of gut dysfunction:
Disorders of gut–brain interaction, including visceral hypersensitivity and altered motility;
Increased intestinal permeability, its drivers, and its downstream immune and symptomatic consequences;
Pathogenic infection and dysbiosis, including the slow and often incomplete recovery of the microbiome after disruption.
Understanding these mechanisms is what allows clinicians to move from naming a syndrome to treating the patient in front of them.
Drawing on current clinical evidence, Dr Brad Leech will outline strategies to modulate visceral hypersensitivity, repair the intestinal barrier, and protect and rebuild the microbiome during and after an insult. The session will provide adaptable, real-world solutions practitioners can tailor to each patient.
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