









































Pa
ge

 
1



Pa
ge

 
10

9

American Journal of  Medical 
Science and Innovation (AJMSI) 

Systematic Review on Current Managements of  Irritable Bowel Syndrome by 
Complementary and Alternative Medicine

Md. Rakib Rased Rana1*, Md. Maniruzzaman2, Md. Sumon Ali3, Md. Monoar Hossen2, Md. Nahid Hasan2, 
Md. Hadisur Rahman Rony2, Saklain Mostak Siam2, Mst. Sajida Atik2, Juyairia Alam2, Md. Shihabur Rahman Hridoy4, 

Kaisar Ahmad Chowdhury5,  Al Mamun Shohag6

Volume 3 Issue 2, Year 2024
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v3i2.3427
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: July 10, 2024
Accepted: August 13, 2024
Published: October 25, 2024

Irritable Bowel Syndrome (IBS) affects people worldwide. It causes physical and emotional 
anguish, typically alongside psychiatric illnesses. When conventional methods of  treating 
irritable bowel syndrome (IBS) fail, patients may go to complementary and alternative 
medicine (CAM) for relief. The quality of  the evidence is uneven, but complementary and 
alternative medicine (CAM) shows promise. A systematic review evaluates CAM efficacy, 
safety, and mechanisms for IBS treatment to identify gaps and guide future research. This 
systematic review evaluates and synthesises CAM’s efficacy and use in irritable bowel syndrome 
treatment. This systematic review (1998-2023) included 15 studies from diverse sources, 
utilizing keywords related to Irritable Bowel Syndrome (IBS). Qualitative data methods 
extracted insights into Complementary and Alternative Medicine (CAM) interventions 
for IBS. The evaluation covered main findings, clinical features, outcomes, adverse effects, 
and follow-up periods. PRISMA-guided data extraction, including a flowchart, ensured a 
systematic approach. Inclusion criteria comprised various study types, while exclusion criteria 
targeted inconsistent data and low-quality studies. This study examines numerous controlled, 
randomised, and multicenter studies on IBS therapies, including Ayurvedic formulations, 
conventional nutrition, and CAM techniques. Participants, study locations, and interventions 
vary in the global study. Results from various studies on IBS therapeutic efficacy, risk 
factors, and patient preferences are shown. Studies on Ayurvedic, homoeopathic, and CAM 
treatments provide a complete overview of  IBS care. The study found that Ayurvedic and 
CAM treatments for IBS are helpful, but mainstream medications are risky. To improve 
efficacy, tailored, culturally relevant programmes need research and standardisation.

Keywords

1 Department of  Public Health, Varendra University, Rajshahi, Bangladesh.
2 Department of  Pharmacy, Varendra University,  Rajshahi, Bangladesh.
3 Department of  Psychology, National University, Rajshahi, Bangladesh.
4 Department of  Pharmacy, Daffodil International University, Dhaka, Bangladesh.
5 Department of  Pharmacy, International Islamic University Chittagong, Chattogram, Bangladesh.
6 Department of  Pharmacy, Dhaka International University, Dhaka, Bangladesh.
* Corresponding author’s e-mail: rakibrana.vu@gmail.com

Ayurvedic, Complementary and 
Alternative Medicine (CAM), 
Homoeopathic, Irritable Bowel 
Syndrome (IBS)

INTRODUCTION
Irritable bowel syndrome (IBS), a prevalent gastrointestinal 
condition, manifests through abdominal discomfort and 
irregular bowel patterns and lacks identifiable causative 
diseases. This chronic disorder varies in intensity, spanning 
from mild to severe symptoms. Diagnosis often follows 
the Rome IV criteria, categorizing it as constipation-
predominant (IBS-C), diarrhoea-predominant (IBS-D), 
or mixed (IBS-M) (Patel et al., 2023; Ford et al., 2020; 
Hongo & Sato, 2006).  The prevalence of  Irritable Bowel 
Syndrome (IBS) varies considerably worldwide. In North 
America, estimates fluctuate between 3% and 20%, 
generally hovering around 10% to 15%. Specifically, in the 
United States, using the Rome IV criteria, approximately 
6.1% of  the population is affected. Meanwhile, in the 
United Kingdom, the prevalence stands at roughly 10.5%, 
whereas in a North Indian community, it’s approximately 
4%. Globally, encompassing Rome III or IV criteria, 
the estimated prevalence of  IBS rests at around 9.2%. 
These variations underscore the diverse geographic and 
diagnostic aspects influencing IBS prevalence rates across 
different populations (Saito et al., 2002; Almario et al., 
2023; Wilson et al., 2004).
Irritable Bowel Syndrome (IBS) exerts a profound impact 
on the well-being of  individuals it afflicts. Its hallmark 

symptoms—abdominal pain, bloating, and irregular 
bowel patterns—not only induce physical discomfort but 
also evoke emotional distress. This condition interlaces 
with psychiatric disorders, with a striking 76% of  IBS 
patients encountering major depressive disorders and 
54% grappling with anxiety disorders. These mental 
health comorbidities further diminish the overall 
quality of  life. IBS doesn’t merely manifest as physical 
impairments; it profoundly affects health-related quality 
of  life, impeding daily functioning. Moreover, dietary 
triggers often provoke or exacerbate IBS symptoms, 
compelling individuals to navigate through dietary 
adjustments and adding to their distress. Consequently, 
managing IBS necessitates not only alleviating symptoms 
but also striving to elevate the overall quality of  life for 
those affected (Khan et al., 2022; Fadgyas Stanculete et al., 
2023; Weber, 2022).
Traditional approaches to managing Irritable Bowel 
Syndrome (IBS) aim at mitigating symptoms through 
dietary modifications and pharmaceutical interventions. 
Dietary adjustments often involve augmenting fibre 
intake or opting for hydrolyzed guar gum, a preference 
observed among a majority of  patients seeking relief. 
Pharmaceuticals prescribed for IBS encompass a 
spectrum such as antispasmodic agents, loperamide, 



Pa
ge

 
11

0

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

antidepressants, alosetron and tegaserod (Hadley & 
Gaarder, 2005). Traditional approaches to treating Irritable 
Bowel Syndrome (IBS) often present inherent challenges. 
Despite encompassing various medications like laxatives, 
antidepressants, antispasmodics, and bulking agents, their 
efficacy and tolerability tend to disappoint many patients. 
Clinical trials haven’t conclusively demonstrated their 
superiority over placebos in providing comprehensive 
relief  from the diverse array of  IBS symptoms. Moreover, 
these therapies come with constraints and limitations, 
underscoring the pressing necessity for treatments that 
empower patients with behavioral self-management 
techniques to alleviate their IBS symptoms (Hulisz, 2004; 
Lackner et al., 2008).
Given the limitations of  current Irritable Bowel 
Syndrome (IBS) treatments, there’s a pressing demand 
for alternative approaches to better manage its 
symptoms comprehensively. Traditional medications 
like antispasmodics, antidiarrheals, and tranquilizers 
haven’t demonstrated consistent effectiveness across all 
IBS symptoms globally. Complementary and Alternative 
Medicine (CAM) modalities, such as herbal treatments, 
acupuncture, and moxibustion, while frequently 
employed, often yield inconclusive or erratic results. 
Psychological therapies like mindfulness and acceptance 
and commitment therapy (ACT) hold promise, yet their 
efficacy varies. Osteopathy has shown some potential 
in alleviating IBS symptom severity. A holistic multi-
disciplinary strategy, integrating lifestyle modifications, 
dietary management, pharmacological interventions, 
psychological approaches, and diverse alternative 
therapies, emerges as a necessity for more comprehensive 
and effective IBS management (Chang & Lu, 2009; Park 
et al., 2013; Sebastián Sánchez et al., 2017).
Complementary and Alternative Medicine (CAM) 
encompasses diverse medical systems and practices rooted 
in various theories, experiences, and philosophies aimed 
at enhancing health and addressing physical and mental 
ailments. These therapies, including acupuncture, dietary 
supplements, reflexology, yoga, massage, chiropractic 
services, Reiki, and aromatherapy, often operate outside 
the realm of  conventional healthcare. While some 
countries are integrating certain CAM approaches into 
mainstream healthcare, their regulatory oversight remains 
limited, raising concerns about the lack of  government 
supervision, particularly by agencies like the Food and 
Drug Administration. This unregulated nature poses 
challenges in recommending and guiding the use of  CAM 
therapies (Moquin et al., 2009; Falkenberg et al., 2012; 
Fowler & Newton, 2006).
Within the realm of  Complementary and Alternative 
Medicine (CAM), an array of  therapies is utilized. This 
includes herbal remedies and acupuncture, often sought 
after for pain alleviation and enhancing one’s overall well-
being. Under the umbrella of  CAM, dietary supplements 
like probiotics find prevalence, while mind-body practices 
such as yoga, meditation, and relaxation techniques 
aid in health maintenance and symptom management 

across various health conditions. Additionally, dietary 
adjustments, incorporating vitamins and minerals, 
constitute another prevalent approach within CAM 
practices (Williamson et al., 2003; Lunny & Fraser, 2010; 
Barnes et al., 2008).
The surge in the utilization of  Complementary and 
Alternative Medicine (CAM) approaches to address 
chronic conditions such as Irritable Bowel Syndrome 
(IBS) stems from the limitations of  conventional 
treatments, which often prioritize symptom management 
over comprehensive treatment and may yield notable 
side effects. Within the realm of  CAM, therapies like 
herbal or dietary supplements, mind-body practices, 
and acupuncture are garnering increased favour 
among individuals grappling with IBS. Treatments like 
peppermint oil and Iberogast®, hypnotherapy, cognitive 
behaviour therapy, and yoga have shown promise in 
enhancing treatment outcomes for IBS patients. For 
instance, herbal remedies like peppermint oil and specific 
probiotics have demonstrated efficacy, while mind-body 
interventions such as hypnotherapy and cognitive-
behavioural therapy have exhibited effectiveness for a 
subset of  patients (Chey et al., 2011; Magge & Wolf, 2013; 
Grundmann, 2014).
The impetus behind exploring Complementary and 
Alternative Medicine (CAM) for Irritable Bowel Syndrome 
(IBS) management lies in the limitations inherent in 
conventional treatments and the prevalent adoption of  
CAM modalities by individuals with IBS. Conventional 
approaches for IBS often centre on mitigating symptoms 
yet may fall short of  providing comprehensive relief  and, 
at times, yield considerable side effects, creating an efficacy 
disparity. Consequently, a substantial number of  IBS 
sufferers seek out CAM therapies encompassing herbal 
remedies, dietary supplements, mind-body practices, 
and various alternative modalities. These therapies are 
perceived as natural and beneficial, with some showcasing 
the potential to assuage abdominal discomfort and elicit 
a holistic response in managing IBS symptoms (Billings 
et al., 2021; Hussain & Quigley, 2006; Parlar Kılıc et al., 
2020).
Complementary and alternative medicine (CAM), 
encompassing herbal treatments, dietary supplements, and 
mind-body approaches, presents promising avenues for 
managing abdominal pain and overall response in Irritable 
Bowel Syndrome (IBS), yet the collective evidence quality 
remains limited. Specific CAM modalities, including 
soluble fibre, peppermint oil, probiotics, hypnotherapy, 
and cognitive-behavioural therapy, have demonstrated 
efficacy in alleviating IBS symptoms. Herbal remedies 
like peppermint oil and Iberogast(®), alongside mind-
body interventions, have showcased enhanced treatment 
outcomes in individuals with IBS. The inclusion of  
acupuncture and moxibustion has exhibited benefits in 
ameliorating symptom severity, addressing abdominal 
discomfort, and enhancing the quality of  life among IBS 
patients. Nevertheless, comprehensive, methodologically 
robust clinical trials are imperative to delve deeper into 



Pa
ge

 
11

1

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

the effectiveness of  CAM interventions in addressing 
the complexities of  IBS symptoms.(Shen & Nahas, 2009; 
Yang et al., 2022).
The aim of  this systematic review is to comprehensively 
assess the efficacy, safety, and potential mechanisms of  
action underlying various Complementary and Alternative 
Medicine (CAM) modalities used in the treatment of  
Irritable Bowel Syndrome (IBS). The primary objectives 
include analyzing the collective effectiveness of  CAM 
interventions in alleviating IBS symptoms, evaluating 
their safety profiles, and elucidating potential mechanisms 
through which these modalities exert their therapeutic 
effects. Additionally, the review aims to identify gaps 
in existing research, ascertain the quality of  evidence, 
and offer insights into promising avenues for future 
investigation into CAM treatments for IBS.

MATERIALS AND METHODS 
Search Strategy
This systematic review considered studies from 1998 to 
2023 and finally included 15 studies. The authors have 
collected data from Pubmed, Google Scholar,  Cochrane, 
Researchgate, Scopus, ScienceDirect, and other online 
libraries. The search process involved the use of  specific 
keywords related to Irritable Bowel Syndrome (IBS), such 
as “irritable Bowel Syndrome (IBS),” “complementary and 
alternative medicine (CAM),” “constipation-predominant 
(IBS-C),” “diarrhoea-predominant (IBS-D),” and “mixed 
(IBS-M).” These keywords were carefully selected to 
ensure a broad yet focused scope, encompassing different 
aspects and management approaches of  IBS. Additionally, 

the inclusion of  specific subtypes like IBS-C, IBS-D, and 
IBS-M also included the application of  complementary 
and alternative medicine across different presentations of  
IBS. Qualitative data collection methods were utilized to 
extract relevant information regarding the management 
of  IBS using complementary and alternative medicine. 
The literature search focused on articles providing 
insights into the effectiveness, outcomes, and patient 
experiences related to CAM interventions for IBS. This 
comprehensive approach aimed to present a nuanced 
and up-to-date overview of  the current state of  
complementary and alternative medicine in managing 
Irritable Bowel Syndrome.

Evaluation
The review evaluated the main findings of  each study, 
clinical features of  each study, primary and secondary 
outcomes and the respective adverse effects. The follow-
up period was also evaluated and recorded for each study. 
This enabled us to evaluate the various outcomes that are 
possible with IBS. The spectrum of  adverse events have 
also been considered. This review also considered various 
drugs and medicines that have been employed in each 
study for the treatment of  IBS. The evaluation of  studies 
widely conducted bring a better picture of  available 
complementary and alternative medicines for the proper 
management of  IBS. 

Data Extraction
This research used a PRISMA-compliant systematic 
review methodology. From the databases, 82 records were 

Figure 1: PRISMA flowchart of  this study



Pa
ge

 
11

2

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

initially retrieved. After using automation technologies to 
remove 15 duplicate records and indicate 18 as ineligible, 
49 records were screened. 14 were excluded due to access 
restrictions. Although the study attempted to retrieve 35 
reports, 14 were unsuccessful. Afterwards, 19 reports were 
reviewed to determine their eligibility; however, 4 were 
excluded since their data were inconsistent. According 
to the last stage, “Included,” fifteen studies were 
included in the review. A PRISMA flowchart provides 
a clear and organised visual representation of  the data, 
allowing one to understand the study selection process 
easily. By following a systematic approach, the review’s 
methodology is made clear and reproducible, increasing 
the reliability of  the studies included in the research.

Inclusion and Exclusion Criteria
Inclusion

● This study included randomised,  cross-sectional, 
control and descriptive-analytical papers.

● This study included irritable bowel syndrome cases 
included in this paper.

● This study considered only the English language.
● This study included from 1998 to 2023.

Exclusion
● Inconsistent data were excluded from this paper.
● Review articles or similar papers were also excluded 

from this study.
● Low quality, insufficient data, and lack of  response 

papers were excluded from this study.

RESULTS AND DISCUSSION
Results
Table 1 summarises studies on Irritable Bowel Syndrome 
treatments. Research of  many kinds is covered in the 
studies. These include controlled studies, randomised 
controlled trials (RCTs), and multicenter research. 
Traditional Ayurvedic formulations, conventional 
nutritional therapy, and complementary and alternative 
medicine (CAM) methods are among the medicines or 
therapies that have been studied. The global exploration 
of  treatments for irritable bowel syndrome is reflected 
in the heterogeneity of  research with respect to the 
number of  participants, country of  study, and specific 
interventions. In order to assess the efficacy, safety, 
and possible action mechanisms of  various therapies 
in symptom management of  irritable bowel syndrome 
(IBS), the data provides a thorough baseline.

Table 1: Baseline characteristics of  the studies included in this review
Studies Type of  Study Medicine investigated No. of  patients Country of  

study
Teja D Naik et al. 
(2023)

Randomised 
controlled parallel 
group study

Kalingadi churna,wsap 48 Karnataka

Dania chumann et al. 
(2022)

Randomised study Ayurvedic or conventional 
nutritional therapy, 
FODMAP

69 Germany

Sally Brabyn et al. 
(2019)

Randomised 
controlled trials 

Homoeopathic remedy, 
asafoetida or asafoetida plus 
nux vomica, IBS-C

307 UK

Virginia Sánchez-
Monroy et al. (2021)

RCT archibel, Isnes, Belgium 41 Mexico 

L. Langmead (2006) Randomised, 
controlled Oral

Aloe Vera Gel, Wheatgrass 
Juice, Boswellia Serrata

153 London 

Diego Curro et al. 
(2016)

randomised 
controlled trials

Anti-diarrheal drugs, bile salt 
sequestrants and antibiotics

1225 Rome

Lena Oxelmark et al. 
(2016)

controlled study CAM 854 Gothenburg 

Qian Yang et al. 
(2022)

multicenter study CAM 730 China

Richard W. 
McCallum et al. 
(2015)

Randomised 
controlled trials

Vitamin and Mineral 61 Australia

Ronald L. Koretz et 
al. (2004)

randomised 
controlled trials

CAM 258 US

GA Moody et al. 
(1998)

RCT Homoeopaths and Herbalists 82 UK

L. Langmead et al. 
(2001)

RCT Herbal medicines 760 UK



Pa
ge

 
11

3

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

Khadijeh Hatami et 
al. (2020)

Randomised clinical 
trial.

Some herbal medicines, 
Maybeverine

40 UK

Cesar Ramos-Remus 
MD et al. (2008)

RCT non-conventional remedies, 
complementary medicine 
and/or alternative therapies

100 Mexico

H Vahedi et al. (2010) RCT Homoeopathic medicines 100 Iran

Table 2 provided a comprehensive analysis of  findings 
from various studies on Irritable Bowel Syndrome 
(IBS). Teja D Naik et al. (2023) observed significant 
improvements in clinical evaluation scales after a 4-week 
study, with higher scores indicating worse conditions. 
Dania Schumann et al. (2022) assessed expectations 
and disappointments over three months, revealing that 
Ayurvedic treatment reduced IBS-SSS. Sally Brabyn et al. 
(2019) identified bias in three 2-week studies on global 
IBS improvement, with low and high-risk bias domains. 
Virginia Sánchez-Monroy et al. (2021) reported that 
individualized homeopathic treatment reduced symptom 
intensity after 3 months. L. Langmead (2006) evaluated 
risk factors associated with alternative therapy over 
3 months, revealing low success rates and substantial 
adverse effects of  traditional therapies. Diego Curro 
et al. (2016) examined complementary therapies over 
a year but found few conclusive outcomes due to the 
absence of  repeating RCTs. Lena Oxelmark et al. (2016) 
found natural product use and CAM benefits in 83.1% 

of  patients. Tiziana Larussa et al. (2019) identified a 
higher BMI and better CAM knowledge after 3 months, 
suggesting improved patient education. Qian Yang et 
al. (2022) noted the incidence of  organic illnesses in 
probable IBS patients throughout 4 months. Richard W. 
McCallum et al. (2015) suggested that CAM therapy might 
reduce recurring stomach discomfort. Ronald L. Koretz 
et al. (2004) examined probiotics for childhood diarrhoea 
over 90 days. GA Moody et al. (1998) discussed CAM’s 
benefits for inflammatory bowel illness over four months. 
L. Langmead et al. (2001) found cumin more effective 
than mebeverine over one year. Cesar Ramos-Remus MD 
et al. (2008) identified 12-month advantages of  alternative 
musculoskeletal pain therapies. Over three months, H 
Vahedi et al. (2010) highlighted the HPA axis and chronic 
anxiety in IBS pathogenesis, and the decreased incidence 
of  stomach discomfort, diarrhoea, and constipation. This 
research evaluated the efficacy of  IBS therapy, identified 
risk factors, and explored patient preferences.

Table 2: Evaluation of  findings of  the included studies
Studies Clinical Features 

of  IBS
Follow-
up 
period

Primary Outcome Secondary 
Outcome

Adverse Effect

Teja D 
Naik et al. 
(2023)

Higher scores 
indicate worse 
conditions

4 weeks mild IBS, moderate 
IBS and severe IBS 
. A decrease of  50 
points is associated 
with an improvement 
in clinical symptoms.

Visual Analog Scale Within-group 
significant 
improvements were 
observed on all 
clinical assessment 
scales in both 
groups.

Dania 
Schumann 
et al. (2022)

Expectations 
and frustrations 
were observed in 
patients

3 
months

The estimated 
marginal means of  
reduction were in 
the Ayurvedic and 
conventional groups. 
The reduction 
in IBS-SSS was 
significantly higher 
in the Ayurveda 
group than in the 
conventional therapy 
group

The higher the IBS-
SSS score and the 
higher the patients' 
expectations, 
the greater the 
reduction in IBS-
SSS observed

There were no 
significant group 
differences in any 
of  the secondary 
outcome measures. 
No serious adverse 
events occurred in 
either group.



Pa
ge

 
11

4

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

Sally 
Brabyn et 
al. (2019)

Risk of  bias was 
noted in three 
studies

2 weeks The primary 
outcome was global 
improvement in 
IBS as measured by 
an IBS symptom 
severity score

Secondary 
outcomes included 
quality of  life, 
abdominal pain, 
stool frequency, 
stool consistency, 
and adverse events

Four domains were 
at low risk of  bias 
and two were at high 
risk of  bias

Virginia 
Sánchez-
Monroy et 
al. (2021)

Symptom severity 
decreased 
significantly after 
3 months of  
treatment, pain 
scores decreased 
after 1 month of  
treatment.

4 
months

The study found 
that the severity 
of  symptom 
scores decreased 
significantly after 3 
months of  treatment, 
while the pain scores 
decreased after 1 
month of  treatment.

Emphasises the 
importance of  
individual medicinal 
approaches using 
LM potency, 
although the 
initial reduction 
of  pain may also 
be due to the fact 
that Lycopodium 
clavatum and Nux 
vomica were the 
main homeopathic 
medicines, and 
these medicines 
contain a variety 
of  alkaloids, which 
have significant 
analgesic effects 
on pain caused 
by physical and 
chemical stimuli. 
showed

The study suggests 
that individualised 
homoeopathic 
treatment using LM 
potency benefits IBS 
patients.

L. 
Langmead 
(2006)

Alternative 
therapies have been 
shown to have 
more risk factors 
than any other 
form

3 
months

Conventional 
therapies have shown 
very low success rates

Can cause serious 
side effects and can 
include fatal liver 
and kidney failure

Knowledge of  long-
term sequelae such 
as mutagenicity and 
carcinogenicity is 
still poorly observed

Diego 
Curro et al. 
(2016)

Probiotics may 
have a role in 
alleviating some 
symptoms of  IBS. 
OR was 1.6 for 
dichotomous data 
from seven trials; 
SMD was 0.23 for 
continuous data 
from six trials

1 year Several therapeutic 
approaches have 
been explored as 
complementary 
or alternative 
to traditional 
pharmacological 
treatments, including 
probiotics, prebiotics, 
synbiotics, fibre and 
herbal medicines

Due to increasing 
consumer spending 
on nutritional and 
healthy dietary 
supplements 
globally, their 
market has shown 
consistent growth 
over the past few 
years.

No definitive 
conclusions can 
be drawn due to 
the lack of  RCTs 
that replicate 
results obtained in 
individuals. Research 
conducted so far.



Pa
ge

 
11

5

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

Lena 
Oxelmark 
et al. (2016)

One died patient 1 month After adjusting for 
age, sex, geographic 
residence and diet 
in a multivariate 
analysis, a statistically 
significant difference 
was observed.

The most 
commonly used 
natural products 
used by patients are 
omega 3, probiotics, 
aloe vera, vitamins, 
arctic root and 
other herbal 
products. Omega 
3, Echinacea spp., 
kan yang, Siberian 
ginseng, arctic root 
and herbal products 
have been used in 
control.

In all, 83.1% 
patients experienced 
positive effects from 
CAM and 14.4% 
experienced negative 
effects.

Tiziana 
Larussa et 
al. (2019)

Adjusted Odds 
Ratio, 95% 
Confidence Interval 
of  Significant Risk 
Factors for CAM 
Use

3 
months

A higher BMI and 
better knowledge of  
CAM were observed

Time of  
childbearing was a 
protective factor. 
Only 19% of  
patients used CAM 
due to medical 
advice. However, a 
minority of  patients 
had complete 
satisfaction with 
CAM.

This willingness 
to reuse suggests 
that health-
care providers’ 
knowledge and 
patient education 
should be improved.

Qian Yang 
et al. (2022)

The prevalence 
of  organic disease 
among patients 
with suspected 
IBS was 10.41%. 
Warning signs for 
organic disease 
include PPV 
anaemia, faecal 
occult blood, and 
unintentional 
weight loss

4 
months

There was a 
prevalence of  organic 
disease in patients 
with suspected IBS

The PPV and miss 
diagnosis rate for 
the diagnosis of  
IBS were 91.67% 
and 74.77% when 
all alarm symptoms 
were combined with 
Rome IV.

Only rectal 
occult blood, 
unintentional weight 
loss, and anemia 
were associated 
with Rome IV, 
respectively.

Richard W. 
McCallum 
et al. (2015)

Decreased 
incidence 
of  recurrent 
abdominal pain 
associated with 
constipation, 
diarrhoea, or both

3 
months

Abdominal pain, acid 
reflux/heartburn, 
digestive allergies, 
liver conditions, 
nausea/vomiting 
and ulcers. The most 
commonly used 
methods were herbal, 
complementary 
and mind body and 
manipulative therapy

This explosive use 
of  CAM therapies 
has created 
opportunities in 
recent years for 
the Centers for 
Complementary 
and Alternative 
Medicine and the 
National Institutes 
of  Health to 
strongly support 
alternative medicine.

There were 
several Chinese 
and Ayurvedic 
preparations that 
were found to be 
better than placebo 
with no serious 
adverse effects.

Ronald L. 
Koretz et al. 
(2004)

Probiotics 
were beneficial 
in childhood 
diarrhoea or 
diarrhoea caused by 
antibiotics

90 days Ginger has been 
found to be effective 
in relieving nausea 
and vomiting caused 
by motion sickness 
or pregnancy.

Homeopathy is 
effective in treating 
gastrointestinal 
problems or 
symptoms.

Gastroenterologists 
should be familiar 
with these 
techniques; It is 
probably already 
their patients.



Pa
ge

 
11

6

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

GA Moody 
et al. (1998)

Many patients 
with inflammatory 
bowel disease have 
benefited

4 
months

There was no 
significant difference 
in consultation rates 
between Asian and 
European patients 
with IBD.

Most patients 
were advised to 
continue their 
current medications, 
although two 
were asked to 
stop and 10 were 
advised to reduce 
their allopathic 
medication dosage.

Many patients with 
IBD believed them 
to be helpful.

L. 
Langmead 
et al. (2001

Drug and Placebo 
and Standardization 
Preparetion 
Placebos and drug 
in both powder and 
capsule form were 
similar in shape, 
color and smell.

1 year Cumin was more 
effective than 
mebeverine in 
reducing the severity 
of  IBS symptoms. 
Subgroups were 
correct for this 
analysis.

Cumin powder 
was more effective 
in improving IBS 
quality of  life 
than mebeverine. 
Obstructions were 
also statistically 
significant except 
for changes in 
food abstinence 
in both groups. 
In composition 
analysis, cumin 
was significantly 
more effective than 
mebeverine

In Persian medicine, 
it is believed that 
every substance has 
efficacy

Cesar 
Ramos- 
Remus MD 
et al.(2008)

Benefits from 
musculoskeletal 
pain syndromes

12 
months

Musculoskeletal pain 
syndromes involving 
the spine and 
extremities were the 
most common

Patients sought 
both physical and 
alternative care

53% reported 
some degree of  
efficacy in patients 
using alternative 
treatments.

H Vahedi et 
al. (2010)

Decreased 
incidence of  
abdominal 
pain, diarrhoea, 
constipation or 
both diarrhoea and 
constipation

3 
months

Activates the 
hypothalamic-
pituitary-adrenal 
(HPA) axis and the 
autonomic system

Chronic anxiety 
increases amygdalar 
activity leading 
to formation 
of  an HPA axis 
that ultimately 
induces visceral 
hyperalgesia.

important role in the 
pathophysiology of  
IBS.21

Discussion
The investigation into CAM for IBS reveals widespread 
adoption of  diverse therapies. Hussain and Quigley’s 
review (2006) underscores the prevalent use of  CAM, 
often as standalone or complementary to conventional 
treatments. However, most lack robust clinical trials, 
primarily small-scale and low-quality studies, though 
interventions like hypnotherapy, specific herbal 
treatments, tailored diets, and probiotics show promise. 
Recognizing CAM’s prevalence among IBS patients, 
healthcare providers should acknowledge its potential 
benefits, particularly in certain therapies, but the scarcity 
of  high-quality trials emphasizes the need for rigorous 
scientific exploration to validate and broaden CAM’s role 
in IBS management .
Billings et al. (2021) meta-analysis explored CAM’s efficacy 
in IBS. Among herbal therapy, dietary supplements, and 

mind-body approaches, there were potential benefits 
over placebo, notably for abdominal pain. However, the 
confidence in these estimates remained low. Meanwhile, 
body-based and energy healing therapies didn’t show 
significant advantages. Overall, the evidence quality for 
CAM in IBS treatment was considered low, underscoring 
the need for high-quality trials to further explore their 
effectiveness (Hussain & Quigley, 2006).
Amsallem et al. (2021) review examined non-
pharmacological interventions for IBS. Body-directed 
therapies like acupuncture and osteopathy showed 
promise in improving overall IBS symptoms compared 
to standard treatment at the 6-month mark. However, 
no clear advantage was observed over sham therapies 
for abdominal pain or overall symptoms. The evidence 
remained inconclusive regarding the superiority of  
hypnotherapy over standard treatment or supportive 



Pa
ge

 
11

7

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

therapy. The review emphasized the potential benefits 
of  body-directed therapies but highlighted the need for 
higher-quality studies to firmly establish their clinical 
efficacy in managing IBS (Amsallem et al., 2021).
A systematic review by Bu et al. (2020) aimed to determine 
the effectiveness and safety of  Tuina (therapeutic 
massage) compared to no treatment or routine medical 
treatment for irritable bowel syndrome (IBS). The study 
delved into 8 trials involving 545 participants diagnosed 
with IBS-diarrhea or IBS-constipation, employing various 
Tuina manipulations. Despite all trials being in Chinese, 
the analysis found inconclusive evidence that Tuina alone 
significantly outperformed routine treatments for IBS-
diarrhea in overall symptom improvement (>30% score 
enhancement) but suggested that Tuina combined with 
routine treatments might yield better results than routine 
treatments alone (Bu et al., 2020).
A systematic review by Yang et al. (2022) was conducted 
in which 31 randomized controlled trials examined the 
efficacy of  acupuncture and moxibustion for Irritable 
Bowel Syndrome (IBS). Acupuncture showcased 
a significant reduction in symptom severity when 
compared to pharmaceutical drugs (-35.45; 95% CI, 
-48.21 to -22.68; I 2 = 71%). The trial sequential analysis 
(TSA) demonstrated acupuncture’s effectiveness. In 
contrast, acupuncture did not exhibit a marked reduction 
in symptom severity but did show therapeutic benefits 
in alleviating abdominal pain compared to sham 
acupuncture (SMD, -0.24; 95% CI, -0.48 to -0.01; I 2 = 
8%). Moxibustion presented considerable therapeutic 
benefits in symptom severity (SMD, -3.46, 95% CI, -5.66 
to -1.27, I 2 = 95%) and abdominal pain (SMD, -2.74, 
95% CI, -4.81 to -0.67, I 2 = 96%) compared to sham 
moxibustion. Both acupuncture and moxibustion showed 
superior benefits for abdominal pain when compared to 
pharmacological medications and shams (SMD, -0.46; 
95% CI, -0.68 to -0.24; I 2 = 47% for acupuncture 
and SMD, -2.00; 95% CI, -3.04 to -0.96; I 2 = 90% for 
the combination of  acupuncture and moxibustion). 
Furthermore, both acupuncture (MD, 4.56; 95% CI, 1.46-
7.67; I 2 = 79%) and moxibustion (MD, 6.97; 95% CI, 
5.78-8.16; I 2 = 21%) showed significant improvements 
in quality of  life compared to pharmaceutical drugs (Zhu 
et al., 2018).
Complementary and Alternative Medicine (CAM) 
modalities exhibit promising potential in mitigating 
Irritable Bowel Syndrome (IBS) symptoms, often 
showcasing superiority over conventional treatments. 
Acupuncture, notably, has demonstrated enhanced 
efficacy in managing diarrhoea-predominant IBS 
compared to pharmaceutical drugs, offering relief  with 
notably fewer side effects. Additionally, peppermint oil 
stands out as a safe and effective remedy for alleviating 
pain and overall symptoms in adult IBS patients. However, 
despite their effectiveness, conventional therapies like 
drugs frequently accompany side effects, varying in 
severity. For instance, rifaximin, alosetron, ramosetron, 
and pinaverium bromide showcase differing degrees of  

side effects in diarrhoea-predominant IBS. Rifaximin and 
alosetron rank higher in side effect severity, while sham 
acupuncture and acupuncture exhibit notably milder side 
effects (Alammar et al., 2019; Bahrami et al., 2016).
Although Complementary and Alternative Medicine 
(CAM) enjoys widespread use for addressing Irritable 
Bowel Syndrome (IBS), discussions within the 
provided literature scarcely delve into the safety aspects 
or potential adverse effects associated with these 
interventions. Limited information indicates that certain 
herbal remedies may pose side effects or interact with 
conventional medications, underlining the necessity for 
extensive clinical investigations to evaluate their safety 
and efficacy. Specific references acknowledge potential 
safety concerns linked to herbal formulas utilized in 
IBS treatment. Consequently, while CAM therapies may 
present promising advantages for managing IBS, their 
safety profiles necessitate comprehensive assessment. 
Patients are strongly advised to seek guidance from 
healthcare professionals before initiating any new 
treatment regimen (Shen & Nahas, 2009; Thompson et 
al., 2013).
CAM therapies encompass a spectrum of  approaches 
potentially alleviating IBS symptoms through diverse 
mechanisms. For instance, herbal remedies such as 
peppermint oil might exhibit antibacterial properties 
and could influence the gut microbiota, offering relief. 
Acupuncture is believed to enhance gut motility and 
modulate the neuroendocrine system within the brain-gut 
axis, potentially contributing to symptom improvement. 
Moxibustion, a traditional Chinese medicine technique, 
is suggested to impact both the brain-gut axis and 
the immune system, potentially aiding in symptom 
management. Additionally, therapies like hypnotherapy 
and cognitive behaviour therapy are presumed to assist 
in stress management, a factor closely associated with 
IBS symptoms. These varied CAM modalities potentially 
offer relief  via multifaceted mechanisms (Huang et al., 
2014; Isolauri et al., 2016).
CAM therapies offer diverse advantages in alleviating 
symptoms associated with Irritable Bowel Syndrome 
(IBS). Soluble fibre emerges as a potential remedy for 
enhancing constipation and mitigating overall IBS 
symptoms, while peppermint oil demonstrates efficacy 
in alleviating abdominal pain. Various modalities within 
CAM, such as specific herbal therapies, hypnotherapy, 
cognitive behaviour therapy, acupuncture, and yoga, 
showcase improved treatment outcomes for individuals 
grappling with IBS. Probiotics present an overall 
beneficial impact on IBS; however, the definitive 
effectiveness of  distinct strains remains less discernible. 
Additionally, certain Chinese herbal medicines exhibit 
promising efficacy in alleviating symptoms experienced 
by individuals with IBS. These diverse CAM interventions 
present multifaceted approaches for addressing different 
aspects of  IBS symptoms (Bi et al., 2018; Nee & Lembo, 
2021).
The future trajectory of  Complementary and Alternative 



Pa
ge

 
11

8

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

Medicine (CAM) in alleviating symptoms of  IBS may 
entail explorations into probiotics, acupuncture, and 
exercise. Probiotics, with their potential to positively 
modify gut bacteria, stand as a promising avenue for 
enhancing digestive processes. Despite varied outcomes, 
acupuncture, when administered by qualified practitioners, 
holds promise as a potential relief  for IBS symptoms. 
Additionally, regular physical exercise emerges as a feasible 
and potentially effective treatment strategy for managing 
IBS symptoms. These avenues highlight evolving paths 
within CAM, indicating potential directions for future 
research and therapeutic interventions for individuals 
grappling with IBS (Alammar et al., 2019).

CONCLUSION
This study concluded that clinical therapies for Irritable 
Bowel Syndrome (IBS) are developed by synthesising 
numerous data. Traditional Ayurvedic methods, 
conventional treatments, and CAM are all part of  the 
investigations, which range from randomised controlled 
trials to multicenter studies. Some research has shown 
that Ayurvedic and CAM treatments are effective, 
whereas other research has pointed out the dangers of  
mainstream medicine and the biases in study designs. 
The results highlight the importance of  creating unique 
treatment plans for irritable bowel syndrome (IBS) that 
account for cultural differences and patient expectations. 
Further research and standardisation efforts are needed to 
improve treatment efficacy and address the complicated 
character of  irritable bowel syndrome (IBS), as the 
complexity of  the condition has been revealed through 
global treatments. Despite promising results in Ayurvedic 
and CAM treatments for Irritable Bowel Syndrome 
(IBS), the study highlights a critical research gap in 
the risk associated with mainstream medications. The 
heterogeneous nature of  interventions and participant 
demographics in global studies calls for standardized, 
culturally relevant programs to enhance efficacy. Future 
research should focus on refining and tailoring these 
treatments, conducting large-scale trials, and establishing 
standardized protocols. This study contributes by 
emphasizing the need for further investigation into 
safe and effective IBS management, paving the way for 
improved clinical practices and patient outcomes.

REFERENCES 
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, 

G., Shinohara, R. T., & Mullin, G. E. (2019). The 
impact of  peppermint oil on the irritable bowel 
syndrome: A meta-analysis of  the pooled clinical data. 
BMC Complementary and Alternative Medicine, 19(1), 21. 
https://doi.org/10.1186/s12906-019-2434-9

Almario, C. V., Sharabi, E., Chey, W. D., Lauzon, M., 
Higgins, C. S., & Spiegel, B. M. R. (2023). Prevalence 
and burden of  illness of  Rome IV irritable bowel 
syndrome in the United States: Results from a 
nationwide cross-sectional study. Gastroenterology, 
165(6), 1475–1487. https://doi.org/10.1053/j.

gastro.2023.07.012
Amsallem, F., Sanchez, S., Armoiry, X., & Mion, F. 

(2021). Effectiveness of  non-pharmacological 
interventions for irritable bowel syndrome: A 
systematic review. Evidence-Based Complementary and 
Alternative Medicine, 2021, 6610662. https://doi.
org/10.1155/2021/6610662

Bahrami, H. R., Hamedi, S., Salari, R., & Noras, M. 
(2016). Herbal medicines for the management of  
irritable bowel syndrome: A systematic review. 
Electronic Physician, 8(8), 2719–2725. https://doi.
org/10.19082/2719

Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). 
Complementary and alternative medicine use among 
adults and children: United States, 2007. National 
Health Statistics Reports, 12, 1–23.

Bi, Z., Zheng, Y., Yuan, J., & Bian, Z. (2018). The efficacy 
and potential mechanisms of  Chinese herbal medicine 
on irritable bowel syndrome. Current Pharmaceutical 
Design, 23(34), 5163–5172. https://doi.org/10.2174/
1381612823666170911151905

Billings, W., Mathur, K., Craven, H. J., Xu, H., & Shin, 
A. (2021). Potential benefit with complementary and 
alternative medicine in irritable bowel syndrome: 
A systematic review and meta-analysis. Clinical 
Gastroenterology and Hepatology, 19(8), 1538–1553.e14. 
https://doi.org/10.1016/j.cgh.2020.11.038

Bu, F. L., Han, M., Lu, C. L., Liu, X. H., Wang, W. G., Lai, J. 
L., Qiu, X. H., He, B. X., Zhang, H., Robinson, N., Fei, 
Y. T., & Liu, J. P. (2020). A systematic review of  Tuina 
for irritable bowel syndrome: Recommendations for 
future trials. Complementary Therapies in Medicine, 52, 
102504. https://doi.org/10.1016/j.ctim.2020.102504

Chang, F. Y., & Lu, C. L. (2009). Treatment of  irritable 
bowel syndrome using complementary and alternative 
medicine. Journal of  the Chinese Medical Association, 
72(6), 294–300. https://doi.org/10.1016/S1726-
4901(09)70376-3

Chen, J. D. Z., Ni, M., & Yin, J. (2018). Electroacupuncture 
treatments for gut motility disorders. 
Neurogastroenterology and Motility, 30(7), e13393. 
https://doi.org/10.1111/nmo.13393

Chey, W. D., Maneerattaporn, M., & Saad, R. (2011). 
Pharmacologic and complementary and alternative 
medicine therapies for irritable bowel syndrome. Gut 
and Liver, 5(3), 253–266. https://doi.org/10.5009/
gnl.2011.5.3.253

Coronel, M., Artifon, E. L. A., Lata, J., Tortoretto, V., 
Arataque, T. P. P., Amorin, R. B. P., de Souza, G. V., 
Bfbh, de M., & de Moura, D. T. H. (2019). Updated 
analysis of  irritable bowel syndrome: A review of  the 
literature. Revista de Gastroenterologia Del Peru, 39(4), 
355–361.

Deutsch, J. K., Levitt, J., & Hass, D. J. (2020). 
Complementary and alternative medicine for 
functional gastrointestinal disorders. The American 
Journal of  Gastroenterology, 115(3), 350–364. https://
doi.org/10.14309/ajg.0000000000000499



Pa
ge

 
11

9

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

Fadgyas-Stanculete, M., Ismaiel, A., Popa, S.-L., & 
Capatina, O. O. (2023). Irritable bowel syndrome and 
resilience. Journal of  Clinical Medicine, 12(13), 4220. 
https://doi.org/10.3390/jcm12134220

Falkenberg, T., Lewith, G., Roberti di Sarsina, P., von 
Ammon, K., Santos-Rey, K., Hök, J., Frei-Erb, M., 
Vas, J., Saller, R., & Uehleke, B. (2012). Towards 
a pan-European definition of  complementary 
and alternative medicine – A realistic ambition? 
Complementary Medicine Research, 19(Suppl. 2), 6–8. 
https://doi.org/10.1159/000343125

Florance, B.-M., Frin, G., Dainese, R., Nébot-Vivinus, 
M.-H., Marine Barjoan, E., Marjoux, S., Laurens, 
J.-P., Payrouse, J.-L., Hébuterne, X., & Piche, 
T. (2012). Osteopathy improves the severity of  
irritable bowel syndrome: A pilot randomized sham-
controlled study. European Journal of  Gastroenterology & 
Hepatology, 24(8), 944–949. https://doi.org/10.1097/
MEG.0b013e328354f194

Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, 
M. (2020). Irritable bowel syndrome. The Lancet, 
396(10263), 1675–1688. https://doi.org/10.1016/
S0140-6736(20)30464-0

Fowler, S., & Newton, L. (2006). Complementary and 
alternative therapies: The nurse’s role. The Journal 
of  Neuroscience Nursing, 38(4), 261–268. https://doi.
org/10.1097/01376517-200608000-00009

Grundmann, O. (2014). Complementary and alternative 
medicines in irritable bowel syndrome: An integrative 
view. World Journal of  Gastroenterology, 20(2), 346–362. 
https://doi.org/10.3748/wjg.v20.i2.346

Hadley, S. K., & Gaarder, S. M. (2005). Treatment of  
irritable bowel syndrome. American Family Physician, 
72(12), 2501–2506.

Hongo, M., & Sato, Y. (2006). Disease concept and 
definition of  irritable bowel syndrome. Nihon Rinsho. 
Japanese Journal of  Clinical Medicine, 64(8), 1415–1419.

Huang, R., Zhao, J., Wu, L., Dou, C., Liu, H., Weng, 
Z., Lu, Y., Shi, Y., Wang, X., Zhou, C., & Wu, H. 
(2014). Mechanisms underlying the analgesic effect 
of  moxibustion on visceral pain in irritable bowel 
syndrome: A review. Evidence-Based Complementary and 
Alternative Medicine, 2014, Article 895914. https://doi.
org/10.1155/2014/895914

Hulisz, D. (2004). The burden of  illness of  irritable bowel 
syndrome: Current challenges and hope for the future. 
Journal of  Managed Care Pharmacy, 10(4), 299–309.

Hussain, Z., & Quigley, E. M. M. (2006). Systematic 
review: Complementary and alternative medicine in 
the irritable bowel syndrome. Alimentary Pharmacology 
& Therapeutics, 23(4), 465–471. https://doi.
org/10.1111/j.1365-2036.2006.02797.x

Isolauri, E., Salminen, S., & Rautava, S. (2016). Early 
microbe contact and obesity risk: Evidence of  
causality? Journal of  Pediatric Gastroenterology and 
Nutrition, 63(1S), S3–S5. https://doi.org/10.1097/
MPG.0000000000001303

Kearney, D. J., & Brown-Chang, J. (2008). Complementary 

and alternative medicine for IBS in adults: Mind–body 
interventions. Nature Clinical Practice Gastroenterology & 
Hepatology, 5(11), 624–636. https://doi.org/10.1038/
ncpgasthep1262

Khan, E. H., Ahamed, F., Karim, M. R., Roy, P., 
Ahammed, S. U., Moniruzzaman, M., & Podder, B. 
R. (2022). Psychiatric morbidity in irritable bowel 
syndrome. Mymensingh Medical Journal, 31(2), 458–465.

Lackner, J., Jaccard, J., Krasner, S., Katz, L., Gudleski, G., 
& Holroyd, K. (2008). Self-administered cognitive 
behavior therapy for moderate to severe irritable 
bowel syndrome: Clinical efficacy, tolerability, 
feasibility. Clinical Gastroenterology and Hepatology, 6(8), 
899–906. https://doi.org/10.1016/j.cgh.2008.03.002

Lembo, A., Ameen, V. Z., & Drossman, D. A. (2005). 
Irritable bowel syndrome: Toward an understanding 
of  severity. Clinical Gastroenterology and Hepatology, 
3(8), 717–725. https://doi.org/10.1016/S1542-
3565(05)00643-8

Lunny, C. A., & Fraser, S. N. (2010). The use of  
complementary and alternative medicines among 
a sample of  Canadian menopausal-aged women. 
Journal of  Midwifery & Women’s Health, 55(4), 335–343. 
https://doi.org/10.1016/j.jmwh.2009.12.003

Magge, S. S., & Wolf, J. L. (2013). Complementary and 
alternative medicine and mind–body therapies 
for treatment of  irritable bowel syndrome in 
women. Women’s Health, 9(6), 557–567. https://doi.
org/10.2217/whe.13.55

Makharia, G. K., Verma, A. K., Amarchand, R., Goswami, 
A., Singh, P., Agnihotri, A., Suhail, F., & Krishnan, 
A. (2011). Prevalence of  irritable bowel syndrome: A 
community-based study from northern India. Journal 
of  Neurogastroenterology and Motility, 17(1), 82–87. 
https://doi.org/10.5056/jnm.2011.17.1.82

Moquin, B., Blackman, M. R., Mitty, E., & Flores, S. 
(2009). Complementary and alternative medicine 
(CAM). Geriatric Nursing, 30(3), 196–203. https://doi.
org/10.1016/j.gerinurse.2009.03.002

Nee, J., & Lembo, A. (2021). Review article: Current and 
future treatment approaches for IBS with diarrhoea 
(IBS-D) and IBS mixed pattern (IBS-M). Alimentary 
Pharmacology & Therapeutics, 54(S1), S63–S74. https://
doi.org/10.1111/apt.16567

Oka, P., Parr, H., Barberio, B., Black, C. J., Savarino, E. V., 
& Ford, A. C. (2020). Global prevalence of  irritable 
bowel syndrome according to Rome III or IV criteria: 
A systematic review and meta-analysis. The Lancet 
Gastroenterology & Hepatology, 5(10), 908–917. https://
doi.org/10.1016/S2468-1253(20)30217-X

Park, J.-W., Lee, B.-H., & Lee, H. (2013). Moxibustion 
in the management of  irritable bowel syndrome: 
Systematic review and meta-analysis. BMC 
Complementary and Alternative Medicine, 13(1), 247. 
https://doi.org/10.1186/1472-6882-13-247

Parlar Kılıç, S., Kılıç, N., Sevinç, S., & Demirel, C. 
(2020). A qualitative study of  the experiences of  
complementary and alternative medicine of  patients 



Pa
ge

 
12

0

https://journals.e-palli.com/home/index.php/ajmsi

Am. J. Med. Sci. Innov. 3(2) 109-120, 2024

with IBS-C. Holistic Nursing Practice, 34(5), 291–300. 
https://doi.org/10.1097/HNP.0000000000000406

Patel N, Shackelford KB. (2022). Irritable Bowel 
Syndrome. NIH.gov.

Ranjbar, S., Seyednejad, S. A., Nikfar, S., Rahimi, R., & 
Abdollahi, M. (2019). How can we develop better 
antispasmodics for irritable bowel syndrome? Expert 
Opinion on Drug Discovery, 14(6), 549–562. https://doi.
org/10.1080/17460441.2019.1608153

Saito, Y. A., Schoenfeld, P., & Locke, G. R. (2002). The 
epidemiology of  irritable bowel syndrome in North 
America: A systematic review. The American Journal 
of  Gastroenterology, 97(8), 1910–1915. https://doi.
org/10.1111/j.1572-0241.2002.05913.x

Sebastián Sánchez, B., Gil Roales-Nieto, J., Ferreira, 
N. B., Gil Luciano, B., & Sebastián Domingo, J. J. 
(2017). New psychological therapies for irritable 
bowel syndrome: Mindfulness, acceptance and 
commitment therapy (ACT). Revista Española de 
Enfermedades Digestivas, 109(9), 648–657. https://doi.
org/10.17235/reed.2017.4860/2017.

Shen, Y. H., & Nahas, R. (2009). Complementary and 
alternative medicine for treatment of  irritable bowel 
syndrome. Canadian Family Physician, 55(2), 143–148.

Thompson, A., Meah, D., Ahmed, N., Conniff-Jenkins, R., 
Chileshe, E., Phillips, C. O., Claypole, T. C., Forman, 
D. W., & Row, P. E. (2013). Comparison of  the 
antibacterial activity of  essential oils and extracts of  
medicinal and culinary herbs to investigate potential 
new treatments for irritable bowel syndrome. BMC 
Complementary and Alternative Medicine, 13(1), 338. 
https://doi.org/10.1186/1472-6882-13-338

Weber, H. C. (2022). Irritable bowel syndrome and 
diet. Current Opinion in Endocrinology, Diabetes, and 

Obesity, 29(2), 200–206. https://doi.org/10.1097/
MED.0000000000000676

Werlang, M. E., Palmer, W. C., & Lacy, B. E. (2019). 
Irritable bowel syndrome and dietary interventions. 
Gastroenterology & Hepatology, 15(1), 16–26.

Williamson, A. T., Fletcher, P. C., & Dawson, K. A. 
(2003). Complementary and alternative medicine: Use 
in an older population. Journal of  Gerontological Nursing, 
29(5), 20–28. https://doi.org/10.3928/0098-9134-
20030501-07

Wilson, S., Roberts, L., Roalfe, A., Bridge, P., & Singh, 
S. (2004). Prevalence of  irritable bowel syndrome: 
A community survey. The British Journal of  General 
Practice, 54(504), 495–502.

Yang, Y., Rao, K., Zhan, K., Shen, M., Zheng, H., Qin, S., 
Wu, H., Bian, Z., & Huang, S. (2022). Clinical evidence 
of  acupuncture and moxibustion for irritable bowel 
syndrome: A systematic review and meta-analysis 
of  randomized controlled trials. Frontiers in Public 
Health, 10, Article 860751. https://doi.org/10.3389/
fpubh.2022.860751

Yang, Y., Rao, K., Zhan, K., Shen, M., Zheng, H., Qin, S., 
Wu, H., Bian, Z., & Huang, S. (2022). Clinical evidence 
of  acupuncture and moxibustion for irritable bowel 
syndrome: A systematic review and meta-analysis 
of  randomized controlled trials. Frontiers in Public 
Health, 10, Article 860751. https://doi.org/10.3389/
fpubh.2022.860751

Zhu, L., Ma, Y., Ye, S., & Shu, Z. (2018). Acupuncture 
for diarrhoea-predominant irritable bowel syndrome: 
A network meta-analysis. Evidence-Based Complementary 
and Alternative Medicine, 2018, Article 2948238. 
https://doi.org/10.1155/2018/2948238


