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Complementary and alternative medicine for treatment of irritable bowel syndrome

Richard Nahas, MD CCFP
Lecturer in the Department of Family and Community Medicine at the University of Ottawa in Ontario and Medical Director of Seekers Centre for Integrative Medicine

Correspondence: Dr Richard Nahas, Seekers Centre for Integrative Medicine, 6 Deakin St, Ottawa, ON K2E 1B3; telephone 613 727-7246; e-mailrichard{at}seekerscentre.com

OBJECTIVE To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS).

QUALITY OF EVIDENCE MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions.

MAIN MESSAGE Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses.

CONCLUSION Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.

This article has been cited by other articles:

				R. V. Birtwhistle Irritable bowel syndrome: Are complementary and alternative medicine treatments useful? Can Fam Physician, February 1, 2009; 55(2): 126 - 127. [Full Text] [PDF]

				R. V. Birtwhistle Syndrome du colon irritable: Les traitements complementaires et de medecine douce sont-ils utiles? Can Fam Physician, February 1, 2009; 55(2): 128 - 129. [Full Text] [PDF]

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