IBS and multidisciplinary care

Gastroenterological nurse (2)

Jimmy Lee - Research Dietitian, 02 May 2024

What is multidisciplinary care?

Multidisciplinary care refers to healthcare services that are provided by multiple professionals across various specialties in medical treatment. Healthcare professionals may come from the same healthcare organisation or from different organisations, but brought together as a specialised team for patient care (1).

Multidisciplinary care is an approach studied in various conditions, with some showing superiority to usual treatment plans, whereby only one healthcare professional is involved in treating one patient (2-4).

Why a multidisciplinary approach in IBS?

Despite the wide prevalence of IBS, the cause of IBS is not clearly known and is thought to be complicated, and may be attributed to one or more biological, psychological and social factors. IBS can also greatly reduce the quality of life in patients and affect productivity, social lifestyle and relationships with friends and family (5).

Traditionally, IBS is managed with medication and mainly by a gastroenterologist (6). However, given the complex nature of IBS, a multidisciplinary model of care that looks beyond gut dysfunction and considers gut-brain and gut-diet interaction is thought to better optimise symptom control, quality of life, psychological health and nutritional wellbeing (than being managed solely by a gastroenterologist). A review in 2021 pointed out that open communication across the multidisciplinary team allows clinical issues to be addressed collaboratively, producing a synergistic effect as part of clinical care (6).

A focus group study in 2021 showed that a multidisciplinary team is preferred by IBS patients, as this approach ensures patients receive knowledgeable and comprehensive care from medical and dietary perspectives (7). A 2023 review pointed out that up to 1 in 3 IBS patients also suffer from anxiety or depression, further highlighting the importance of treating IBS in a multidisciplinary approach (8).

The evidence

In a 2020 Melbourne-based study, 144 patients with functional gastrointestinal disorders were randomly assigned to receive either multidisciplinary clinic care or standard care (involving a gastroenterologist only) (9). In IBS patients, a higher proportion of patients reported a clinically significant reduction in symptoms between baseline and end of treatment in the multidisciplinary group (66%), compared to the standard group (38%), and this difference was also observed 12 months after the end of treatment (10). Specialists in the multidisciplinary arm had immediate access to allied health professionals within the same clinic, which the authors mentioned was crucial to the success of treatment.

Another study also showed that a greater proportion of functional gastrointestinal disorders patients achieved symptom, quality of life and psychological health improvement in those who received multidisciplinary care, compared to gastroenterologist-only or standard care (11).

Until recently, IBS treatment often focused on using medication (5), which may be limited in its effectiveness (5, 8), potentially due to the lack of addressing how the gut and the brain can manifest symptoms. The 2021 British Society of Gastroenterology guidelines on the management of IBS recognise that a multidisciplinary approach is usually required to manage patients with severe IBS symptoms (12,13), although there is limited evidence to guide management of this approach in this population (12).

What role does each healthcare professional in the multidisciplinary team play?

We have summarised the roles that individual healthcare professionals play in the multidisciplinary team in the infographic below. Members of the multidisciplinary team may be individualised according to the patient’s clinical needs (1).


Last but not least and often overlooked, family members also play an important role in IBS multidisciplinary care. Showing support and extending a helping hand to your loved ones is possibly the ultimate treatment for IBS!

In conclusion, an integrated model where behavioural, medical, dietary (5), psychological and social interventions are considered as equal partners is most likely to be successful in managing IBS. We are hoping to see more high-quality evidence evaluating the efficacy and establishing guidelines for this approach. In turn, clinical practices adopt a multidisciplinary and holistic approach in IBS treatment, whereby health experts from various specialisations can unite and work with patients to enhance accessible and individualised IBS care.


  1. NSW Health. Multidisciplinary Team Care [Internet]. Nsw.gov.au. NSW Health; 2014. Available from: https://www.health.nsw.gov.au/healthone/Pages/multidisciplinary-team-care.aspx
  2. Lahiri M, Cheung PPM, Dhanasekaran P, Wong SR, Yap A, Tan DSH, et al. Evaluation of a multidisciplinary care model to improve quality of life in rheumatoid arthritis: a randomised controlled trial. Quality of Life Research. 2021 Nov 6;31(6):1749–59.
  3. Wolfs CAG, Kessels A, Dirksen CD, Severens JL, Verhey FRJ. Integrated multidisciplinary diagnostic approach for dementia care: randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science [Internet]. 2008 Apr 1 [cited 2020 Oct 16];192(4):300–5. Available from: https://pubmed.ncbi.nlm.nih.gov/18378994/
  4. Li D, Sun CL, Kim H, Soto-Perez-de-Celis E, Chung V, Koczywas M, et al. Geriatric Assessment–Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults With Cancer. JAMA Oncology. 2021 Nov 18;7(11):e214158.
  5. Chey WD, Keefer L, Whelan K, Gibson PR. Behavioral and Diet Therapies in Integrated Care for Patients with Irritable Bowel Syndrome. Gastroenterology. 2020 Oct;160(1).
  6. Chang FY. Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments. World Journal of Gastroenterology. 2014;20(10):2499.
  7. Masclee GMC, Snijkers JTW, Boersma M, Masclee AAM, Keszthelyi D. Patient preferences of healthcare delivery in irritable bowel syndrome: a focus group study. BMC Gastroenterology. 2021 Nov 23;21(1).
  8. Staudacher HM, Black CJ, Teasdale SB, Mikocka-Walus A, Keefer L. Irritable bowel syndrome and mental health comorbidity — approach to multidisciplinary management. Nature Reviews Gastroenterology & Hepatology. 2023 Jun 2;20(9):1–15.
  9. Basnayake C, Kamm MA, Stanley A, Wilson-O’Brien A, Burrell K, Lees-Trinca I, et al. Standard gastroenterologist versus multidisciplinary treatment for functional gastrointestinal disorders (MANTRA): an open-label, single-centre, randomised controlled trial. The Lancet Gastroenterology & Hepatology. 2020 Oct;5(10):890–9.
  10. Basnayake C, Kamm MA, Stanley A, Wilson-O’Brien A, Burrell K, Lees-Trinca I, et al. Long-Term Outcome of Multidisciplinary Versus Standard Gastroenterologist Care for Functional Gastrointestinal Disorders: A Randomized Trial. Clinical Gastroenterology and Hepatology. 2021 Dec;20(9).
  11. Bray N, Koloski NA, Jones MP, Do A, Pang S, Coombes JS, et al. Evaluation of a Multidisciplinary Integrated Treatment Approach Versus Standard Model of Care for Functional Gastrointestinal Disorders (FGIDS): A Matched Cohort Study. Digestive Diseases and Sciences. 2022 Apr 1;67(12):5593–601.
  12. Vasant DH, Paine PA, Black CJ, et al., British Society of Gastroenterology guidelines on the management of irritable bowel syndromeGut 2021;70:1214-1240.
  13. Simrén M, Törnblom H, Palsson OS, Whitehead WE. Management of the multiple symptoms of irritable bowel syndrome. The Lancet Gastroenterology & Hepatology. 2017 Feb;2(2):112–22.
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