Psychological Therapies in Patients with Irritable Bowel Syndrome

A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Osama Altayar, Varun Sharma, Larry J. Prokop, Amit Sood, Mohammad H Murad

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background. Irritable bowel syndrome (IBS) is a poorly understood disease with few effective treatments. Psychosocial factors are believed to contribute to the pathogenesis of IBS. Objective. To evaluate the evidence for psychological therapies in IBS treatment. Methods. We searched six medical databases through February 6, 2014, for randomized controlled trials (RCTs) of psychological therapies for the treatment of IBS. Two independent reviewers identified the RCTs, extracted the data, and assessed trial quality. We used the random-effect model to pool standardized mean difference (SMD) and 95% confidence interval (CI) across trials. Results. 15 RCTs that mostly evaluated cognitive behavioral therapy were included. Psychological therapies were associated with improvement in IBS symptoms severity scales (SMD -0.618; 95% CI: -0.853 to -0.383), IBS-Quality of Life (SMD 0.604; 95% CI: 0.440 to 0.768), and abdominal pain (SMD -0.282; 95% CI: -0.562 to -0.001). No statistically significant effect was observed on diarrhea or constipation. Limitations. The trials were at increased risk of bias and the overall sample size was small leading to imprecision. Conclusion. Psychological therapies may improve the quality of life and symptom severity in IBS. The effect size noted is moderate to large and is clinically meaningful.

Original languageEnglish (US)
Article number549308
JournalGastroenterology Research and Practice
Volume2015
DOIs
StatePublished - 2015

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Irritable Bowel Syndrome
Meta-Analysis
Randomized Controlled Trials
Psychology
Confidence Intervals
Therapeutics
Quality of Life
Cognitive Therapy
Constipation
Sample Size
Abdominal Pain
Diarrhea
Databases

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Psychological Therapies in Patients with Irritable Bowel Syndrome : A Systematic Review and Meta-Analysis of Randomized Controlled Trials. / Altayar, Osama; Sharma, Varun; Prokop, Larry J.; Sood, Amit; Murad, Mohammad H.

In: Gastroenterology Research and Practice, Vol. 2015, 549308, 2015.

Research output: Contribution to journalArticle

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abstract = "Background. Irritable bowel syndrome (IBS) is a poorly understood disease with few effective treatments. Psychosocial factors are believed to contribute to the pathogenesis of IBS. Objective. To evaluate the evidence for psychological therapies in IBS treatment. Methods. We searched six medical databases through February 6, 2014, for randomized controlled trials (RCTs) of psychological therapies for the treatment of IBS. Two independent reviewers identified the RCTs, extracted the data, and assessed trial quality. We used the random-effect model to pool standardized mean difference (SMD) and 95{\%} confidence interval (CI) across trials. Results. 15 RCTs that mostly evaluated cognitive behavioral therapy were included. Psychological therapies were associated with improvement in IBS symptoms severity scales (SMD -0.618; 95{\%} CI: -0.853 to -0.383), IBS-Quality of Life (SMD 0.604; 95{\%} CI: 0.440 to 0.768), and abdominal pain (SMD -0.282; 95{\%} CI: -0.562 to -0.001). No statistically significant effect was observed on diarrhea or constipation. Limitations. The trials were at increased risk of bias and the overall sample size was small leading to imprecision. Conclusion. Psychological therapies may improve the quality of life and symptom severity in IBS. The effect size noted is moderate to large and is clinically meaningful.",
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