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National Institutes of Health • National Center for Complementary and Integrative Health

NCCIH Clinical Digest. For health professionals.

Complementary Health Approaches for Irritable Bowel Syndrome

July 2015
Woman sitting on bed holding stomach, head bowed

Irritable bowel syndrome (IBS)—a chronic disorder that interferes with the normal functions of the colon—is challenging to study because of its varied, non-specific symptoms, episodic nature and the lack of confirmatory diagnostic testing. Although there is emerging evidence suggesting that some complementary health practices may be used for treating IBS, most of the studies have methodological flaws. Systematic reviews evaluating complementary modalities for IBS symptoms have concluded that few large, well-designed studies exist and further research is required to determine whether complementary or integrative health practices are effective for treating IBS.

This issue summarizes the research on commonly used complementary and integrative health approaches for managing symptoms of IBS.

Modality
Summary of Evidence

Probiotics

a Natural Product

There is some preliminary evidence that suggests some probiotics may improve symptoms of IBS; however, benefits have not been conclusively demonstrated, and not all probiotics have the same effects. The American College of Gastroenterology issued a monograph in 2014 on the management of IBS and chronic idiopathic constipation, stating that “taken as a whole, probiotics improve global symptoms, bloating, and flatulence in IBS,” but recommendations cannot be made at this time regarding species, preparations, or strains due to insufficient and conflicting data.

Read more about the evidence base of probiotics for IBS

Hypnotherapy

a Mind and Body Approach

Some studies have suggested benefit of hypnotherapy for IBS symptoms, including gastrointestinal symptoms, anxiety, depression, disability, and health-related quality of life. Significant relief from pain-related functional gastrointestinal pain disorders in children has been reported after hypnotherapy compared with standard care or wait-list approaches. However, the American College of Gastroenterology issued a monograph in 2014 on the management of IBS and chronic idiopathic constipation, concluding that a variety of psychological interventions, including hypnotherapy, are effective in improving IBS symptoms, assigning the recommendation as “weak” and the quality of evidence as “very low.”

Read more about the evidence base of hypnotherapy for IBS

Peppermint Oil

a Natural Product

There is some evidence that enteric-coated peppermint oil capsules may be modestly efficacious, in the short-term, in reducing several common symptoms of IBS, in particular abdominal pain, bloating, and gas. Long-term efficacy has not been established. A 2011 Cochrane review found statistically significant benefits for peppermint oil. The American College of Gastroenterology issued a monograph in 2014 on the management of IBS and chronic idiopathic constipation, concluding that “peppermint oil is superior to placebo in improving IBS symptoms,” and “the risk of adverse events is no greater with peppermint oil than with placebo.” However, based on the evidence, they assigned the recommendation as “weak” and the quality of evidence as “moderate.”

Read more about the evidence base of peppermint oil for IBS

Herbal Remedies

a Natural Product

The evidence that herbal remedies might improve IBS symptoms is very limited.

Read more about the evidence base of herbal remedies for IBS

Acupuncture

a Mind and Body Approach

In sham-controlled, randomized trials, acupuncture was found to be no better than placebo for IBS symptom severity or health-related quality of life. In Chinese studies, acupuncture appeared to provide greater benefits than two antispasmodic drugs (pinaverium bromide and trimebutine maleate), although these benefits may have been due to patient preferences or expectations of improvement.

Read more about the evidence base of acupuncture for IBS

Homeopathy

a Natural Product

There is insufficient evidence to support homeopathy as an effective treatment for IBS or any other specific condition.

Read more about the evidence base of homeopathy for IBS

Clinical Guidelines

Scientific Literature

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NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH's Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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