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Review
. 2009 Feb;55(2):143-8.

Complementary and alternative medicine for treatment of irritable bowel syndrome

Yi-Hao A Shen  1 , Richard Nahas
Affiliations
Review

Complementary and alternative medicine for treatment of irritable bowel syndrome

Yi-Hao A Shen et al. Can Fam Physician. 2009 Feb.

Abstract
in English, French

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.

OBJECTIF: Examiner les preuves en faveur de l’utilisation de certaines thérapies complémentaires et alternatives dans le traitement du syndrome du côlon irritable (SCI).

QUALITÉ DES PREUVES: On a fouillé MEDLINE (depuis janvier 1966), EMBASE (depuis janvier 1980) et la Cochrane Database of Systematic Reviews jusqu’en mars 2008, en combinant les termes irritable bowel syndrome ou irritable colon avec complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, probiotic, hypnotherapy, psychotherapy, cognitive therapy ou behavior therapy. Parmi les résultats, seuls les essais cliniques, les revues systématiques et les méta-analyses ont été retenus. La plupart des interventions présentaient des preuves de niveau I.

PRINCIPAL MESSAGE: Les fibres solubles soulagent la constipation et la plupart des symptôme du SCI. L’huile de menthe poivrée soulage les symptômes du SCI, incluant les douleurs abdominales. Les essais sur les probiotiques indiquent qu’ils sont généralement bénéfiques mais il y a peu de preuves en faveur d’une souche en particulier. L’hypnothérapie et la thérapie cognitivo-comportementale sont également des options valables pour certains patients. Un nombre limité de données appuient l’usage d’herbes médicinales, mais leur innocuité pourrait être source de préoccupations. Toutes les interventions s’appuient sur des revues systématiques ou des méta-analyses.

CONCLUSION: Plusieurs thérapies complémentaires ou alternatives peuvent être recommandées comme partie intégrante d’une approche basée sur des données probantes pour le traitement du SCI; elles pourraient procurer un soulagement satisfaisant et améliorer la relation médecin-patient.

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