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Complementary and alternative medicine for IBS in adults: mind–body interventions

An Article Report to this article was published on 01 February 2009

Abstract

Standard treatment for IBS focuses on the management or alleviation of the predominant gastrointestinal presenting symptoms, such as diarrhea or constipation, often using pharmacological therapy. For many patients, this approach is unsatisfactory, and patients frequently seek the advice of complementary and alternative medicine (CAM) practitioners in order to explore other treatment options. CAM practices include a broad range of modalities, and mind–body interventions hold particular promise as treatment modalities for IBS because psychological factors could have an important role in IBS symptomatology and quality of life. Psychological stressors are postulated to result in gastrointestinal symptoms through alteration of intestinal function mediated by the autonomic nervous system, hypothalamic–pituitary–adrenal axis and immune system. Hypnotherapy has the strongest supportive evidence as a beneficial mind–body intervention for IBS. Clinical studies of hypnotherapy have uniformly shown improvement of gastrointestinal symptoms, anxiety, depression and quality of life in patients with IBS. Mindfulness meditation remains unstudied for IBS, but is theoretically attractive as a stress-reduction technique. There is a suggestion that relaxation therapy or multimodal therapy (a combination of relaxation therapy, education and psychotherapy) is beneficial for IBS. The most generally accepted psychological mind–body intervention is cognitive behavioral therapy, and clinical trials support the beneficial effects of cognitive behavioral therapy in patients with IBS.

Key Points

  • 21–51% of individuals with IBS use complementary and alternative medicine practices

  • Mind–body treatments might improve IBS symptomatology by modulation of the stress response, as described in the biopsychosocial model of medicine

  • Hypnotherapy is an evidence-based treatment for IBS—several trials show improvement of gastrointestinal symptoms, quality of life and reduced medical resource utilization in patients with IBS after hypnotherapy

  • Home-study hypnotherapy programs for IBS remain poorly studied

  • Several studies suggest that patients with IBS benefit more from cognitive behavioral therapy than routine medical care; however, long-term follow-up studies are needed

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Kearney, D., Brown-Chang, J. Complementary and alternative medicine for IBS in adults: mind–body interventions. Nat Rev Gastroenterol Hepatol 5, 624–636 (2008). https://doi.org/10.1038/ncpgasthep1257

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