Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Billings, Wade; Mathur, Karan; Craven, Hannah; Xu, Huiping; Shin, Andrea

doi:10.1016/j.cgh.2020.09.035

Cited by 16 publications

(19 citation statements)

References 87 publications

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“…More and more patients are forced to seek complementary and alternative therapies because of the adverse effects and side effects of drugs [12][13][14]. Acupuncture and moxibustion are the effective treatment for IBS [12,14], and there are several meta-analyses suggested bene ts of acupuncture and moxibustion in terms of symptom control and quality of life improvements in patients with IBS [13,15].…”

Section: Introductionmentioning

confidence: 99%

Mild moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A randomized controlled trial

Wang

Shi

et al. 2022

Journal of Ethnopharmacology

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To evaluate the effects of mild moxibustion (MM) for the treatment of irritable bowel syndrome with diarrhea (IBS-D) through comparisons with those of placebo moxibustion. Patients and Methods:This was a single-site, randomized controlled trial was conducted at Shanghai Research Institute of Acupuncture and Meridian in China and enrolled 76 participants who met the Rome IV diagnostic criteria for IBS-D between May 2017 and December 2019. 76 participants were randomized to either mild moxibustion (MM) or placebo moxibustion group (PM) in a 1:1 ratio. 18 sessions of MM or PM were implemented over the course of 6 weeks (3 times per week). The primary outcome was adequate relief after 6 weeks of treatment. ResultsOf 76 patients with IBS-D who were randomized (38 in the MM group and 38 in the PM group) were included in the intention-to-treat (ITT) analysis set. After treatment at week 6, the response rate was signi cantly higher in the MM group than the PM group (81.58% vs. 36.84%,) with an estimated difference of 44.74 (95% CI, 23.46 to 66.02, P < 0.001). No participant reported severe adverse effects. ConclusionThe ndings suggest that mild moxibustion may be more effective than placebo moxibustion for the treatment of IBS-D, with effects lasting up to 12 weeks.

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Section: Introductionmentioning

confidence: 99%

Mild moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A randomized controlled trial

Wang

Shi

et al. 2022

Journal of Ethnopharmacology

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“…is observation is consistent with a recent systematic review that recommended using an optimal placebo as a control, defined as an experience comparable to the intervention. In the case of an inadequate placebo, the response would be more favorable to the intervention [35]. However, choosing the adequate sham therapy, especially in the field of body-directed therapies, is a difficult task.…”

Section: Discussionmentioning

confidence: 99%

“…Hypnotherapy became popular in the 1980s, when an RCT demonstrated some therapeutic effectiveness [21]. In recent years, hypnotherapy has shown a beneficial impact on IBS symptoms [22][23][24][25][26][27][28][29][30][31][32][33][34] and according to Billings et al [35], mind-body therapies, dietary supplements, and herbal medicine have been shown to be beneficial for abdominal pain and overall IBS symptoms in a setting where evidence of effectiveness is weak.…”

Section: Introductionmentioning

confidence: 99%

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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“…There was no benefit over placebo for abdominal pain, however, for body-based and energy healing therapies. 89 Currently the evidence would not support use of complementary or alternative medicine approaches for IBS pain.…”

Section: Several Complementary and Alternative Medicine Approachesmentioning

confidence: 99%

Review article: current and future treatment approaches for pain in IBS

Paine

2021

Aliment Pharmacol Ther

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SummaryBackgroundAbdominal pain is a core symptom of IBS and a primary driver of care seeking. Visceral hypersensitivity is a key pathophysiological mechanism and therapeutic target for pain in IBS, with components of peripheral and central sensitisation and psychological factors.AimTo review current and future treatment approaches specifically for the pain component of IBS.MethodsPubmed search terms included combinations of irritable bowel, pain, visceral hypersensitivity, novel, new, emerging, future and advances.ResultsEstablished non‐pharmacological treatments for IBS pain include the low FODMAP diet, probiotics and psychological interventions, especially hypnotherapy. Tricyclics remain the best evidenced pharmacological approach with GCC agonists, tenapanor, lubiprostone, eluxadoline and 5HT3 antagonists second line according to patient characteristics and availability. Less well‐evidenced current options include anti‐spasmodics, peppermint oil, SSRIs, SNRIs, alpha 2 delta ligands, melatonin and histamine antagonists. Patients are vulnerable to iatrogenesis and harmful approaches to be avoided include opioids and unwarranted surgical interventions. For severe pain, the concept of augmentation with combined gut‐brain neuromodulators and psychotherapy in a multi‐disciplinary setting is considered. A plethora of molecular targets and ligands are emerging from pre‐clinical studies, together with early clinical evidence for a range of pharmacological, dietary, neurostimulation and novel psychological treatment delivery methods which are reviewed. The history of such emerging approaches, however, merits both caution and optimism in equal measure.ConclusionsDespite good in‐roads and emerging options, the management of abdominal pain remains one of the biggest challenges and research priorities for patients with IBS.

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Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Cited by 16 publications

References 87 publications

Mild moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A randomized controlled trial

Mild moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A randomized controlled trial

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

Review article: current and future treatment approaches for pain in IBS

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