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Review
, 24 (28), 3055-3070

Non-pharmacological Therapies for Inflammatory Bowel Disease: Recommendations for Self-Care and Physician Guidance

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Review

Non-pharmacological Therapies for Inflammatory Bowel Disease: Recommendations for Self-Care and Physician Guidance

Whitney Duff et al. World J Gastroenterol.

Abstract

We performed a scoping review on sought-after complementary therapies for patients with inflammatory bowel disease (IBD), specifically diet, physical activity and exercise (PA/E), and psychotherapy. We aim to update patients with IBD on therapies for self-care and provide physicians with guidance on how to direct their patients for the management of IBD. A search of MEDLINE, EMBASE, and PUBMED was completed in Sept 2016. Studies on diet, PA/E, or psychotherapy in patients with IBD were included. Medical Subject Heading terms and Boolean operators were used. The search was limited to full-text English articles describing an adult population. This review included 67 studies: Diet (n = 19); PA/E (n = 19); and psychotherapy (n = 29). We have made the following recommendations: (1) Diet: Consumption of diets rich in vegetables, fruit and soluble fiber may be beneficial in IBD. A trial of a low FODMAP diet can be considered in those patients with functional gastrointestinal symptoms. Restrictive diets are lacking in evidence and should be avoided; (2) PA/E: Regular low-moderate intensity activity, including cardiovascular and resistance exercise, has been shown to improve quality of life (QOL) and may improve inflammation; and (3) psychotherapy: Therapies such as cognitive-behavioural interventions, mindfulness, hypnosis, and stress management have been shown to improve QOL, but evidence is limited on their impact on anxiety, depression, and disease activity. Overall, these complementary therapies are promising and should be used to treat patients with IBD from a more holistic perspective.

Keywords: Diet; Exercise; Inflammatory bowel disease; Psychotherapy; Scoping review.

Figures

Figure 1
Figure 1
Ovid MEDLINE literature search strategy. Similar searches were run within EMBASE: Excerpta Medica and EMBASE: Classic, PubMed, and PsychINFO databases.
Figure 2
Figure 2
Ovid MEDLINE literature search results. After initial search and limitations, results were further screened by a single expert reviewer.
Figure 3
Figure 3
EMBASE: Excerpta Medica and EMBASE: Classic literature search results. After initial search and limitations, results above and beyond those already identified via Ovid MEDLINE search were further screened by a single expert reviewer.

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