Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults.

Content Provider	Europe PMC
Author	Dai, Yun-Kai Wu, Yun-Bo Li, Ru-Liu Chen, Wei-Jing Tang, Chun-Zhi Lu, Li-Ming Hu, Ling
Copyright Year	2020
Abstract	BACKGROUNDAlthough nonpharmacological interventions (NPI) for irritable bowel syndrome (IBS) have been applied clinically, their relative efficacy and safety are poorly understood.AIMTo compare and rank different NPI in the treatment of IBS.METHODSFive electronic databases were searched from their inception to January 12, 2020. Data of included publications were analyzed using network meta-analysis (NMA). Quality of endpoints were assessed by tools of the Cochrane Handbook and the GRADEpro software. Pooled relative risk or standardized mean difference with their corresponding 95% confidence intervals were used for statistical analysis. Surface under the cumulative ranking curve (SUCRA) probability value was conducted to rank the examined interventions. Sensitivity analysis was performed to verify the robustness of results and test the source of heterogeneity.RESULTSForty randomized controlled trials with 4196 participants were included in this NMA. Compared with routine pharmacotherapies and placebo, acupuncture and cognitive behavioral therapy (CBT) had better efficacy in relieving IBS symptoms. Based on the SUCRA values, acupuncture ranked first in improving overall clinical efficacy and avoiding adverse effects. CBT ranked first in lowering the scores of IBS symptom severity scale, self-rating anxiety scale and self-rating depression scale.CONCLUSIONThis study confirmed the efficacy and safety of NPI for improving IBS symptoms, which to some extent recommended several interventions for clinical practice.
ISSN	10079327
Volume Number	26
PubMed Central reference number	PMC7656202
Issue Number	41
PubMed reference number	33244207
Journal	World Journal of Gastroenterology [World J. Gastroenterol]
e-ISSN	22192840
DOI	10.3748/wjg.v26.i41.6488
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2020-11-01
Access Restriction	Open
Rights License	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Nonpharmacological interventions Irritable bowel syndrome Network meta-analysis Randomized controlled trials Adults Clinical practice
Content Type	Text
Resource Type	Article
Subject	Gastroenterology