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

Abstract

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a high incidence in the general population. The diagnosis of IBS is mainly based on exclusion of other intestinal conditions through the absence of inflammatory markers and specific antigens. The current pharmacological treatment approaches available focus on reducing symptom severity while often limiting quality of life because of significant side effects. This has led to an effectiveness gap for IBS patients that seek further relief to increase their quality of life. Complementary and alternative medicines (CAM) have been associated with a higher degree of symptom management and quality of life in IBS patients. Over the past decade, a number of important clinical trials have shown that specific herbal therapies (peppermint oil and Iberogast^®), hypnotherapy, cognitive behavior therapy, acupuncture, and yoga present with improved treatment outcomes in IBS patients. We propose an integrative approach to treating the diverse symptoms of IBS by combining the benefits of and need for pharmacotherapy with known CAM therapies to provide IBS patients with the best treatment outcome achievable. Initial steps in this direction are already being considered with an increasing number of practitioners recommending CAM therapies to their patients if pharmacotherapy alone does not alleviate symptoms sufficiently.

Keywords: Irritable bowel syndrome; Complementary and alternative medicine; Hypnotherapy; Cognitive behavioral therapy; Herbal therapy; Peppermint

Core tip: Irritable bowel syndrome is a prevalent gastrointestinal disorder that interferes with daily living in 5%-20% of the population. The current review summarizes the most widely used complementary and alternative medicine (CAM) approaches that have proven to be effective and have been endorsed by professional organizations. The review encourages the use of both pharmacotherapy and CAM approaches in an integrative setting to provide the best outcome and quality of life to patients.