Complementary Health Approaches for Irritable Bowel Syndrome
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Complementary Health Approaches for Irritable Bowel Syndrome Vivian Abena Asamoah, MD1 Gerard Mullin, MD2,* Address 1 25230 Kingsland Blvd, Suite #101, Katy, TX, 77494, USA *,2 Department of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Carnegie 464, Baltimore, MD, 21205, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
Keywords Irritable bowel syndrome I Herbal treatment I Gut-brain axis I Low FODMAPS I Probiotics
Abstract Purpose of review Irritable bowel syndrome (IBS) is a common functional disorder with a prevalence of up to 15% in the USA. Patients with IBS are more inclined to seek complementary treatment options for management of their conditions due to a lack of sufficient relief from conventional treatments and preference towards a more natural approach. We reviewed the most up-to-date medical literature regarding complementary health modalities for the treatment of IBS. Recent findings Proposed mechanisms for IBS range from alterations in gut motility, intestinal permeability, intestinal microbiome, visceral hypersensitivity, and brain-gut interactions. Addressing each mechanism has helped to broaden our treatment armamentarium by introducing specific targets to different aspects of the disease mechanisms. Today, treatment options for IBS range from conventional prescription drugs for symptomatic relief, including antibiotics for IBS predominant diarrhea to complementary modalities: specific diets, probiotics, botanical herbal regimens, acupuncture, and mind-body therapies. Summary Numerous complementary health approaches are available to patients and gastroenterologists. There is sound evidence to support the use of such modalities to augment the care and overall quality of life of patients with IBS.
Introduction Irritable bowel syndrome (IBS) affects 15% of the population in the USA, and functional bowel disorders make up to 40% of the visits to the gastroenterologist [1, 2]. Rome IV characterizes IBS by recurrent abdominal
pain weekly for at least 3 months associated with changes in bowel habits; symptoms must have started at least 6 months before establishing a diagnosis. The various subtypes of the disease include IBS-D (diarrhea
Hot Topics predominant), IBS-C (constipation-predominant), or IBS-M (mixed diarrhea and constipation) [3]. Over the years, the complexity and heterogeneity of the mechanisms of IBS have led to a more forward-thinking approach to a disease state than a syndrome. The complexity in the pathophysiological pathways may contribute to the challenges in treating patients with IBS successfully using conventional medicine alone. Thirty percent to 50% of patients with IBS turn to complementary health approaches to manage their condition [4–6]. Complementary health approaches include an array of modalities and products with a history of use or origins outside of conventional Western medicine. Although the words complementary and alternative are often grouped, they are distinct. A National Institute of Health (NIH)
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