Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Dai, Yunkai; Wu, Yunbo; Li, Ru-Liu; Chen, Weijing; Tang, Chunzhi; Lu, Liming; Hu, Ling

doi:10.3748/wjg.v26.i41.6488

Cited by 9 publications

(6 citation statements)

References 83 publications

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“…Our exploratory meta-analysis reported similar results to a recent network meta-analysis [53] regarding the effectiveness and safety of non-pharmacological interventions for IBS symptoms. Although the scope of this paper was different from our study (it included also diet modifications and dietary complements such as probiotics), this study confirmed the potential effectiveness of acupuncture.…”

Section: Discussionsupporting

confidence: 83%

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

Amsallem

Sanchez

Armoiry

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Introduction. Given the complexity of the therapeutic management of irritable bowel syndrome (IBS), alternative non-pharmacological therapies are frequently offered to patients. The aim of this study was to conduct a systematic review in order to establish the current evidence base for non-pharmacological interventions (body-directed and mind-body therapies) in the management of IBS. Materials and Methods. The literature was searched in several electronic databases (PubMed (including Medline), Web of Science (Clarivate Analytics), Scopus (Elsevier), ScienceDirect (Elsevier), Cochrane Library (Wiley), and Wiley Online Library (Wiley)) for randomized controlled trials (RCTs) published in the English language from 1990 to 2020. Effectiveness outcomes were examined through the change in overall IBS symptoms or abdominal pain up to 12 months after treatment. Results. 11 studies (parallel-group RCTs) were identified that enrolled 1590 participants in total. Body-directed therapies (acupuncture and osteopathic medicine) showed a beneficial effect compared with standard medical treatment for overall IBS symptoms at 6 months follow-up, while no study found any difference between body-directed and sham therapies for abdominal pain or overall IBS symptoms. It was not possible to conclude whether hypnotherapy was superior to standard medical treatment or supportive therapy for overall IBS symptoms or abdominal pain due to discordant results. Conclusions. Although body-directed therapies such as acupuncture and osteopathic medicine may be beneficial for overall IBS symptoms, higher-quality RCTs are needed to establish the clinical benefit of non-pharmacological interventions for IBS. An important challenge will be the definition of the optimal control groups to be used in non-pharmacological trials.

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Section: Discussionsupporting

confidence: 83%

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

Amsallem

Sanchez

Armoiry

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Treatment of IBS focuses on symptom management to maintain daily functioning and improve QOL. However, due to significant side effects of prescribed medications, some sufferers do not take multiple CM but instead turn to complementary and alternative therapies for remedy [ 11 , 29 ]. A number of SRs/MAs have investigated the efficacy of acupuncture for IBS patients.…”

Section: Discussionmentioning

confidence: 99%

Quality of Evidence Supporting the Role of Acupuncture for the Treatment of Irritable Bowel Syndrome

Huang

Zheng

et al. 2021

Pain Research and Management

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Objectives. To systematically collate, appraise, and synthesize the current evidence on acupuncture for irritable bowel syndrome (IBS). Methods. Systematic reviews (SRs)/meta-analyses (MAs) of acupuncture for IBS were searched in eight databases. For quality evaluation of the enrolled studies, Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) was used for methodological quality, Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) for reporting quality, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Results. Ten studies were included in our review. According to AMSTAR-2, only one study met all the criteria and was rated as high methodological quality, and the rest were rated as low or very low methodological quality. According to the PRISMA checklist, most of the items were fully reported, with the exception of Q5 (protocol and registration), Q8 (search), and Q27 (funding). With the GRADE system, no outcome measure was rated as high quality. Conclusions. Acupuncture may be a promising therapy for IBS. However, this conclusion must be treated with caution since the quality of SRs/MAs providing evidence is generally low.

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“…Compared with routine pharmacotherapies and placebo, acupuncture and cognitive-behavioral therapy (CBT) had better efficacy in relieving IBS symptoms. Based on the SUCRA values, acupuncture ranked first in improving overall clinical efficacy and avoiding adverse effects [22]. Acupuncture produced a more significant effect than loperamide in weekly defecation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of acupuncture based on acupoint combination theory for irritable bowel syndrome: a study protocol for a multicenter randomized controlled trial

Sun

et al. 2021

Trials

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Background Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, diarrhea or constipation, and changes in defecation patterns. No organic disease is found to explain these symptoms by routine clinical examination. This study aims to investigate the efficacy and safety of acupuncture therapy for IBS patients compared with those of conventional treatments. We also aim to identify the optimal acupoint combination recommended for IBS and to clarify the clinical advantage of the “multiacupoint co-effect and synergistic effect.” Methods and analysis A total of 204 eligible patients who meet the Rome IV criteria for IBS will be randomly stratified into acupuncture group A, acupuncture group B, or the control group in a 1:1:1 ratio with a central web-based randomization system. The prespecified acupoints used in the control group will include bilateral Tianshu (ST25), Shangjuxu (ST37), Neiguan (PC6), and Zusanli (ST36). The prespecified acupoints used in experimental group A will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Neiguan (PC6). The prespecified acupoints used in experimental group B will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Zusanli (ST36). Each patient will receive 12 acupuncture treatments over 4 weeks and will be followed up for 4 weeks. The primary outcome is the IBS-Symptom Severity Scale (IBS-SSS) score. The secondary outcomes include the Bristol Stool Form Scale (BSFS), Work and Social Adjustment Score (WSAS), IBS-Quality of Life (IBS-QOL), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores. Both the primary outcome and the secondary outcome measures will be collected at baseline, at 2 and 4 weeks during the intervention, and at 6 weeks and 8 weeks after the intervention. Ethics and dissemination The entire project has been approved by the ethics committee of the Beijing University of Chinese Medicine (2020BZYLL0903). Discussion This is a multicenter randomized controlled trial for IBS in China. The findings may shed light on the efficacy of acupuncture as an alternative to conventional IBS treatment. The results of the trial will be disseminated in peer-reviewed publications. Trial registration Chinese Clinical Trials Register ChiCTR2000041215. First registered on 12 December 2020. http://www.chictr.org.cn/.

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Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Cited by 9 publications

References 83 publications

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

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

Quality of Evidence Supporting the Role of Acupuncture for the Treatment of Irritable Bowel Syndrome

Efficacy of acupuncture based on acupoint combination theory for irritable bowel syndrome: a study protocol for a multicenter randomized controlled trial

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