Complementary and alternative medicine for treatment of irritable bowel syndrome.
OBJECTIVE
To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS).


METHODS
MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions.


RESULTS
Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses.


CONCLUSIONS
Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.
Shen
Yi-Hao A
YH
Department of Family and Community Medicine at University of Ottawa in Ontario.
Nahas
Richard
R
D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data; D019587:Dietary Supplements; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006990:Hypnosis / Q000379:methods; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D009864:Ontario; D017060:Patient Satisfaction; D008517:Phytotherapy / Q000379:methods; D019936:Probiotics / Q000627:therapeutic use; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile; D016896:Treatment Outcome
D004365:Drugs, Chinese Herbal