Navigating IBS: Pathophysiology, Neuromodulators, and Patient-Centered Care

In this episode of GHAPPcast, the official podcast for Gastroenterology and Hepatology Advanced Practice Providers, host Christina Hanson, NP, is joined by Kim Kearns, NP, to explore the complex pathophysiology of IBS-C (Irritable Bowel Syndrome with Constipation) and the evolving neuromodulation strategies that enhance patient care.

The discussion kicks off by addressing IBS as a disorder of gut-brain interaction (DGBI)—a paradigm shift from the older classification of functional GI disorders. The speakers dive deep into the physiological and neurological pathways that contribute to IBS symptoms, including visceral hypersensitivity, dysbiosis, motility dysfunction, and altered mucosal immunity. Kim and Christina explain how neurotransmitters like serotonin and dopamine play a critical role in gut function, and how disruption in their signaling can exacerbate abdominal pain, bloating, and altered bowel habits.

With a growing arsenal of IBS-C treatments, this episode highlights the clinical utility of neuromodulators such as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Kim shares practical insights into when and how to implement neuromodulation for patients with persistent pain and visceral hypersensitivity while addressing common patient concerns about antidepressant use for GI conditions. The conversation also explores cognitive behavioral therapy (CBT) and gut-directed hypnotherapy as emerging non-pharmacologic interventions that can reduce symptom severity and improve patient outcomes.

A central theme of the episode is patient-centered care and shared decision-making. The speakers emphasize the importance of validating the patient experience, educating them on the biopsychosocial model of IBS, and setting realistic expectations for symptom management. They discuss effective communication strategies, the role of digital therapeutics, and ways to enhance patient-provider trust to ensure adherence to treatment plans.

Tune in to GHAPPcast for this expert-led discussion on best practices for IBS-C management and learn how to integrate neuromodulation, cognitive therapy, and patient education into your clinical approach. For more information, visit GHAPP.org or download the GHAPP ACE app for more information.