A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study.
BACKGROUND
Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear.


AIM
To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics.


METHODS
We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included.


RESULTS
We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12-43) to controls (average n = 25.4 patients; range 12-47), whereas one study compared two active "bonafide" interventions. Psychological treatments varied (cognitive-behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments.


CONCLUSIONS
Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.
['Thakur|Elyse R|ER|', 'Shapiro|Jordan|J|', 'Chan|Johanna|J|', 'Lumley|Mark A|MA|', 'Cully|Jeffrey A|JA|', 'Bradford|Andrea|A|', 'El-Serag|Hashem B|HB|']
D002986:Clinical Trials as Topic D005762:Gastroenterology D006801:Humans D006990:Hypnosis D043183:Irritable Bowel Syndrome D064866:Mindfulness D011613:Psychotherapy D016896:Treatment Outcome
Psychological treatment Irritable bowel syndrome Gastroenterology clinic settings