Effectiveness of Non-Pharmacological Interventions for Irritable Bowel Syndrome: A Systematic Review

Amsallem, Florent; Sanchez, Stéphane; Armoiry, Xavier; Mion, François

doi:10.1155/2021/4404185

Cited by 3 publications

(2 citation statements)

References 50 publications

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“…On one hand, a Cochrane systematic review including17 RCTs reported that the effective rate of acupuncture for IBS was better than pharmacological interventions (Manheimer et al, 2012a), but the pharmacological interventions were sundry and included Chinese herbal formula, probiotics, pinaverium bromide, and sulfasalazine, etc. Another systematic review similarly confirmed that at 6-month follow-up, acupuncture was more beneficial for overall symptoms of IBS compared to standard medical Frontiers in Physiology frontiersin.org treatment (Amsallem et al, 2021). The recent research was validated again and reported that acupuncture may be a more effective treatment than PEG 4000/pinaverium bromide in terms of improving the symptoms of IBS (Pei et al, 2020).…”

Section: Discussionmentioning

confidence: 82%

Acupuncture vs. antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis

Shi

Qian²,

Di³

et al. 2022

Front. Physiol.

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Background: Acupuncture has been extensively applied to manage irritable bowel syndrome (IBS) in clinical practice in China. Some randomized controlled trials (RCTs) have demonstrated their efficacy, but it has rarely been compared with first-line antispasmodics to verify their effectiveness. Therefore, we compare acupuncture with antispasmodics in the treatment of IBS by using an adjusted indirect treatment comparison meta-analysis.Methods: Embase, OVID Medline, and the Cochrane Central Register of Controlled Trials databases were searched from inception to 14 March 2022, with no language restrictions. RCTs comparing antispasmodics or acupuncture with placebo or one of the antispasmodics were enrolled. The primary outcome of interest was the improvement of abdominal pain. And the secondary outcomes of interest were the relief of global IBS symptoms and adverse events. The random-effects model was utilized to pool data. The effect size was measured by standardized mean difference (SMD) or relative ratio, and the effectiveness of acupuncture and different antispasmodics were ranked by P-scores.Results: Thirty-five RCTs (n = 5,190) were included. The analysis showed that cimetropium, drotaverine, acupuncture, and pinarverium were superior over placebo in relieving abdominal pain; cimetropium (SMD, −3.00 [95%CI, −4.47 to −1.53], P-score = 0.99) ranked the most effective. In pairwise comparisons, acupuncture had a greater improvement than most antispasmodics except cimetropium and drotaverine in relieving abdominal pain, although the between-group difference was statistically insignificant. In the analysis of continuous outcome in the relief of global IBS symptoms, the result showed that pinaverium was more effective (SMD, 1.72 [95%CI, 0.53 to 2.92], P-score = 0.90) than placebo. Trimebutine and acupuncture had greater improvements than placebo, but no significant difference was shown between groups. In pairwise comparisons, acupuncture was more effective than pinaverium (SMD, −1.11 [95%CI, −1.94 to −0.28]) in relieving global IBS symptoms. In the analysis of adverse events, acupuncture had a lower adverse event rate than most of the other antispasmodics.Conclusion: Cimetropium, drotaverine, and acupuncture were all better than placebo in improving abdominal pain. Acupuncture was preferred over pinaverium in relieving global IBS symptoms, and acupuncture had lower adverse events than most antispasmodics.

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Section: Discussionmentioning

confidence: 82%

Acupuncture vs. antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis

Shi

Qian²,

Di³

et al. 2022

Front. Physiol.

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“…To date, there is a systematic review from 2014 assessing the effectiveness of OMT for IBS symptoms with promising results [20]; however, it was judged as low in the AMSTAR-2 quality assessment tool by a recent overview of systematic reviews [21]. There are another two systematic reviews from 2021, however, the focus was not only on OMT, as they included other types of interventions, such as physiotherapy, and acupuncture [22,23]. Hence, it was necessary to update the evidence regarding OMT and IBS, and nevertheless a meta-analysis was still missing, therefore this systematic review and meta-analysis aims to summarize the current evidence about the effectiveness of OMT in patients with IBS for the IBS symptoms.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Buffone,

Tarantino,

Belloni

et al. 2023

Healthcare

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The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = −1.14 [−1.66, −0.62]; p < 0.0001) and constipation (ES = −0.66 [−1.12, −0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = −0.34 [−0.83, 0.16]; p = 0.19), and diarrhea (ES = −1.20 [−2.84, 0.43]; p = 0.15). The quality of evidence was “low” for IBS symptoms in general for abdominal pain and constipation, while it was judged as “very low” for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies.

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Análisis de los resultados publicados sobre las afecciones para las que la acupuntura tiene distinto grado de evidencia como opción terapéutica

Carrillo¹

2023

Revista Internacional de Acupuntura

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Effectiveness of Non-Pharmacological Interventions for Irritable Bowel Syndrome: A Systematic Review

Cited by 3 publications

References 50 publications

Acupuncture vs. antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis

Acupuncture vs. antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis

Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Análisis de los resultados publicados sobre las afecciones para las que la acupuntura tiene distinto grado de evidencia como opción terapéutica

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