Official websites use. Share sensitive information only on official, secure websites. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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.
Effectiveness outcomes were examined through the change in overall IBS symptoms or abdominal pain up to 12 months after treatment. 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. 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. IBS symptoms are also associated with mild-to-severe anxiety and depression in two-thirds of patients [ 6 ].
Given the significant demand for care from IBS patients, physicians generally prescribe symptomatic drug therapies, but these have only modest effectiveness [ 7 ]. Indeed, the multifactorial nature of IBS physiopathology, the wide variation in symptoms in terms of severity and progression, and the fairly significant placebo effect may constrain the development of more effective drugs [ 7 β 9 ]. Phytotherapy may have potential beneficial effects, as recently suggested for curcumin by a meta-analysis [ 10 ].
