Are Complementary Therapies Effective for IBS? What the Science Says

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According to the National Center for Complementary and Integrative Health, some evidence is emerging that a few complementary health approaches may be helpful for IBS. However, the research is limited so we don’t know for sure.

Mind and Body Practices for IBS

Acupuncture

  • For easing the severity of IBS, actual acupuncture wasn’t better than simulated acupuncture, a 2012 systematic review reported.
  • A 2009 clinical trial included in the review found that of the 230 participants with IBS, those who received either actual or simulated acupuncture did better than those who received no acupuncture.

Hypnotherapy (hypnosis)

  • Researchers are studying gut-directed hypnotherapy (GDH), which focuses on improving bowel symptoms. Several IBS studies have found an association between hypnotherapy and long-term improvement in gastrointestinal symptoms, anxiety, depression, disability, and quality of life. The American College of Gastroenterology stated in a 2014 paper that there is some evidence that hypnosis helps with IBS symptoms, but the research is very uncertain.
  • Just more than half of study participants who had 10 GDH sessions over 12 weeks felt better, compared with 25 percent of participants not assigned to undergo GDH, a 2013 study of 90 adults with IBS showed. The benefits lasted for at least 15 months. The non-GDH group had the same number of sessions of supportive talks with a physician who was trained in diseases related to stress and other factors.
  • A research review suggested that children with IBS who underwent GDH had greater reductions in abdominal pain than children who received standard treatment. This was true whether the children underwent GDH with a therapist or listened to an audio recording. However, the result may not be reliable, as the researchers found only three small studies that met their standards.
  • Many children and adolescents with mild IBS symptoms who get only reassurance from their health care provider improve over time.

Mindfulness Meditation Training

  • Mindfulness meditation training. Some studies suggest that mindfulness training helps people with IBS, but there’s not enough evidence to draw firm conclusions.
    • The American College of Gastroenterology stated in a 2014 paper that the few studies that have looked at mindfulness meditation training for IBS found no significant effects. But the authors noted that given the limited number of studies, they can’t be sure it doesn’t help. A 2013 review that included these and other studies concluded that mindfulness training improved IBS-associated pain and quality of life but not depression or anxiety. The amount of improvement was small.
  • A 2011 NCCIH-supported clinical trial (which was in the 2013 review) of 75 women with IBS showed that mindfulness training may decrease the severity of IBS symptoms, including psychological distress, compared to attending a support group. The benefits lasted for at least 3 months after the training ended.

Yoga

  • In a small 2014 NCCIH-supported study, young adults (18 to 26 years old) reported generally feeling better and having less pain, constipation, and nausea after completing a series of yoga classes, compared with a waitlist control group. They were still feeling better at the study’s 2-month followup.
  • There’s too little evidence to draw conclusions about the effectiveness of meditation, relaxation training, and reflexology for IBS.

Dietary Supplements for IBS

A variety of dietary supplements, many of which are Chinese herbs and herb combinations, have been investigated for IBS, but we can’t draw any conclusions about them because of the poor quality of many of the studies.

Chinese herbs

In a 2008 systematic review, a combination of Chinese herbs was associated with improved IBS symptoms, but extracts of three single herbs had no beneficial effects.

Peppermint oil

Peppermint oil capsules may be modestly helpful in reducing several common symptoms of IBS, including abdominal pain and bloating. It’s superior to placebo in improving IBS symptoms, the American College of Gastroenterology stated in a 2014 paper.

Probiotics

Generally, probiotics improve IBS symptoms, bloating, and flatulence, the American College of Gastroenterology stated in a 2014 paper. However, it noted that the quality of existing studies is limited. It’s not possible to draw firm conclusions about specific probiotics for IBS in part because studies have used different species, strains, preparations, and doses.

  • IBS patients given probiotics did no better than those who got a placebo, a 2013 clinical trial of 131 patients found. The group received either the placebo or probiotics for 6 months.
  • In a 2012 review, 34 of 42 studies of probiotics for IBS symptoms found greater improvement in people taking probiotics than a placebo. However, the difference in improvement between the probiotic and placebo groups varied a lot among the studies.
  • A 2011 review of studies on a strain of probiotic bacteria showed associations between taking probiotics and a decrease in symptoms in children with IBS.

More to Consider

Unproven products or practices should not be used to replace conventional treatments for IBS or as a reason to postpone seeing a health care provider about IBS symptoms or any other health problem.

  • If you’re considering a practitioner-provided complementary practice such as hypnotherapy or acupuncture, ask a trusted source (such as the health care provider who treats your IBS or a nearby hospital) to recommend a practitioner. Find out about the training and experience of any practitioner you’re considering. For information about selecting a complementary health practitioner go to nccih.nih.gov/health/tips/selecting and nccih.nih.gov/health/howtofind.htm.
  • Keep in mind that dietary supplements may interact with medications or other supplements and may contain ingredients not listed on the label. Your health care provider can advise you. If you’re pregnant or nursing a child, or if you’re considering giving a child a dietary supplement, it’s especially important to consult your (or your child’s) health care provider.
  • Tell all of your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Resource: National Center for Complementary and Integrative Health. “Irritable Bowel Syndrome: In Depth” April 20, 2017.

Key References:

Brandt LJ, Chey WD, Foxx-Orenstein AE, et al. An evidence-based systematic review on the management of irritable bowel syndrome. American Journal of Gastroenterology. 2009;104(Suppl 1):S1-S35.

Clarke G, Cryan JF, Dinan TG, et al. Review article: probiotics for the treatment of irritable bowel syndrome—focus on lactic acid bacteria. Alimentary Pharmacology and Therapeutics. 2012;35(4):403–413.

Ford AC, Moayyedi P, Lacy BE, et al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. American Journal Gastroenterology. 2014;109(suppl 1):S2-S26.

Gaylord SA, Palsson OS, Garland EL, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. American Journal of Gastroenterology. 2011;106(9):1678–1688.

Kaptchuk TJ, Friedlander E, Kelley JM, et al. Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLoS One. 2010;5(12):e15591.

Kearney DJ, Brown-Chang J. Complementary and alternative medicine for IBS in adults: mind-body interventions. Nature Clinical Practice. Gastroenterology & Hepatology. 2008;5(11):624–636.

Lembo AJ, Conboy L, Kelley JM, et al. A treatment trial of acupuncture in IBS patients. American Journal of Gastroenterology. 2009;104(6):1489–1497.

Manheimer E, Cheng K, Wieland LS, et al. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews. 2012;(5):CD005111. Accessed at www.thecochranelibrary.com (link is external) on January 27, 2015.

Moser G, Trägner S, Gajowniczek EE, et al. Long-term success of GUT-directed group hypnosis for patients with refractory irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology. 2013;108(4):602–609.

National Institute of Diabetes and Digestive and Kidney Diseases. Irritable Bowel Syndrome. National Digestive Diseases Information Clearinghouse Web site. Accessed at digestive.niddk.nih.gov/ddiseases/pubs/ibs/#what on January 27, 2015.

Pimentel M, Chang C. Inflammation and microflora. American Journal of Gastroenterology. 2011;40(1):69–85.

Rahimi R, Abdollahi M. Herbal medicines for the management of irritable bowel syndrome: a comprehensive review. World Journal of Gastroenterology. 2012;18(7):589–600.

Ruepert L, Quartero AO, de Wit NJ, et al. Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews. 2011;(8):CD003460. Accessed at www.thecochranelibrary.com (link is external) on January 27, 2015.

Rutten JM, Reitsma JB, Vlieger AM, et al. Gut-directed hypnotherapy for functional abdominal pain or irritable bowel syndrome in children: a systematic review. Archives of Disease in Childhood. 2013;98(4):252–257.

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