Alternative treatments for abdominal pain in irritable bowel syndrome

Abdominal pain is part of the definition of irritable bowel syndrome (IBS) and, according to the ROME IV criteria, must be present at least once a week. This sometimes intense pain can lead to a significant impairment of quality of life. Drug treatments are occasionally insufficient to provide relief to patients and can be poorly tolerated. More than a third of patients rely on treatments from complementary and alternative medicine, usually without discussing these treatments with their doctor. In this context, it seems important to discuss the possibilities of alternative care with patients and to be able to direct patients toward treatments that have demonstrated their effectiveness, especially since most alternative treatments are not covered by the French health care system. Studies investigating the effectiveness of these types of treatment are more complex to perform. There is a particularly high placebo effect in cases of IBS, with more than one in three patients showing improvement by taking a placebo, highlighting the necessity to establish a control group to evaluate treatments. Concerning alternative treatments, selecting the control group is more challenging, and double-blind studies are only rarely feasible. Despite these caveats, studies on hypnosis, cognitive and behavioral therapies, and meditation have demonstrated efficacy for IBS symptoms, particularly abdominal pain. For other techniques, such as osteopathy, auricular vagal stimulation, or yoga, the results of the studies are encouraging but insufficient for formal recommendation. Studies on acupuncture, foot reflexology, and homeopathy do not demonstrate effectiveness superior to placebo.