Complementary and alternative medicines in irritable bowel syndrome: An integrative view

Table 4 Clinical trials on psychological complementary and alternative medicines interventions for irritable bowel syndrome

Intervention	Study design	Sample size	Outcome	Ref.
Hypnotherapy	Pre- and post-assessment	23	Normalized hypersensitivity pain threshold in hypersensitive group (P = 0.04) after 12 wk of treatment, no significant change in hyposensitive and normosensitive groups	[154]
Hypnotherapy	Randomized controlled trial in children with functional abdominal pain or IBS	53	Significant reduction in pain scores in hypnotherapy group (P < 0.001) compared to standard medical therapy at 1-yr after intervention	[159]
Hypnotherapy	Questionnaire	83	69% of patients were either satisfied or very satisfied with hypnotherapy following 12 wk intervention, overall improvement in quality of life and GI symptoms	[160]
Hypnotherapy	Randomized, placebo-controlled study	138 in two studies (90 and 48)	Significant reduction in IBS symptoms in hypnotherapy groups (P < 0.05) compared to supportive therapy after 3 mo of intervention	[161]
Hypnotherapy	Randomized, placebo-controlled study	90	Significant improvement in overall IBS symptoms in gut-directed hypnotherapy and medical treatment group compared to medical treatment group alone (P = 0.046) after 12 wk; improvement remained up to 12 mo after intervention in hypnotherapy group (P = 0.004) compared to medical treatment alone	[162]
Hypnotherapy	Pre- and post-assessment	75	Group hypnotherapy decreased symptom severity significantly (P < 0.01) at 3, 6, and 12 mo post-intervention	[163]
Hypnotherapy	Retrospective analysis	208	Significantly higher use of hypnotherapy (P < 0.001) by initial responders vs non-responders at 2-7 yr follow-up, in total 87% of participants reported hypnotherapy to be useful	[164]
Cognitive behavior therapy	Randomized-comparator-controlled study in patients with functional bowel disorders	431	CBT was more effective than education (P = 0.0001) and desipramine was more effective than placebo (P = 0.01) after 12 wk of treatment as assessed by treatment satisfaction	[170]
Cognitive behavior therapy	Randomized, placebo-controlled study in patients with functional bowel disorders	397	No significant differences between treatment arms for desipramine, cognitive behavior therapy, and placebo groups	[171]
Cognitive behavior therapy and mindfulness training	Randomized controlled trial	195	Internet-delivered cognitive behavior therapy resulted in adequate relief of IBS symptoms that was significant compared to internet-delivered stress management at 6 mo follow-up (P = 0.004)	[173]
Cognitive behavior therapy	Randomized controlled trial	149	Significant reduction in symptom severity scores in CBT plus mebeverine group compared to mebeverine alone at post-treatment and 3, 6, and 12 mo follow-up (regression P = 0.001)	[174]
Psychotherapy [cognitive behavior therapy]	Randomized controlled trial	50	Rome-II scores significantly decreased (P = 0.001) in patients receiving CBT in conjunction with standard medical care compared to standard medical care alone after 2 mo intervention	[175]
Cognitive behavior therapy	Randomized controlled trial	28	Psychosocial functioning was significantly improved (P = 0.004) in patients receiving CBT in addition to standard medical care compare to standard medical care alone at 3 mo follow-up	[176]
Cognitive behavior therapy	Randomized controlled trial	76	Cognitive behavior therapy presented with significant improvements compared to stress management and attention control groups in reducing visceral sensitivity (P < 0.0001) compared to baseline at 3 mo follow-up	[177]
Cognitive behavior therapy	Randomized, placebo-controlled study	85	Internet delivered CBT reduced several IBS symptom parameters (total pain, diarrhea, bloating primary symptoms all P < 0.001) after 10 wk of intervention compared to discussion board control group; quality of life and visceral sensitivity were also significantly improved (P < 0.001) after 3 mo follow up	[179]
Mindfulness training	Randomized controlled trial	75	Women in mindfulness training group showed significant reduction (P = 0.006) in IBS symptom severity compared to support control group after 8 wk of intervention which remained significant at 3 mo follow-up (P = 0.001)	[180]
Cognitive behavior therapy	Retrospective analysis	75	Long-term follow-up after 15-18 mo of original intervention resulted in lasting significant reductions in visceral sensitivity (P < 0.05), increase in quality of life (P < 0.05), and gastrointestinal symptoms (P < 0.05)	[181]

IBS: Irritable bowel syndrome; CBT: Cognitive behavior therapy; GI: Gastrointestinal.