Intermittent Fasting as a Potential Therapeutic Approach for Irritable Bowel Syndrome: A Hypothesis and Mechanistic Perspective

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder marked by abdominal discomfort, altered bowel habits, and comorbidities like anxiety, fatigue, and poor sleep. Existing treatments often fall short of long-term relief and fail to address root causes, leaving many patients with persistent symptoms. This contributes to a substantial burden on individuals and healthcare systems, highlighting the need for new, mechanism-based therapies. Emerging evidence suggests that gastrointestinal symptoms may be caused by the cumulative burden of epithelial injury and insufficient time for mucosal maintenance and repair. This paper explores the hypothesis that structured intermittent fasting regimes could represent a safe, low-cost, and underutilized therapeutic strategy for IBS by promoting gut renewal and restoring homeostasis. We review the multifactorial pathophysiology of IBS and explore how fasting may counter these mechanisms. Evidence from IBS and IBD studies shows that intermittent fasting can reduce inflammation, enhance autophagy, regulate gut motility, and reshape the microbiota, thereby strengthening the gut barrier and dampening immune responses. Notably, fasting induces autophagy, a key cellular recycling process essential for intestinal barrier maintenance and microbial defense, which may be impaired in IBS. Although clinical studies on fasting regimes and IBS are limited, evidence from related populations and mechanistic research supports further exploration. As a practical, circadian-aligned approach that does not restrict specific foods, intermittent fasting may reduce epithelial injury and allow time for repair. The shift from “what to eat” to “when to eat” offers a new, physiology-based potential tool for IBS treatment.