Can Alternative Therapies for Irritable Bowel Disease Really be Effective?

Alternative therapies such as probiotics and synbiotics may be viable options for patients with irritable bowel disorders, according to findings published in the British Journal of Pharmacology.

Researchers from Rome reviewed published literature about the treatments for irritable bowel disorders — like irritable bowel syndrome (IBS), functional constipation, and ulcerative colitis (UC) – to draw some more concrete conclusions about the more unusual or alternative therapies.

The study authors explained that these illnesses greatly impact patients’ qualities of life, and are also particularly expensive. Because of this, there has been a rise for complementary and alternative approaches aside from the traditional pharmacological treatments; the study authors specifically mentioned probiotics, prebiotics, synbiotics, fiber, and herbal medicinal products.

According to the researchers, many studies that investigate these other medicines are biased, mostly due to poor methodology and/ or small study samples.

It did appear that probiotics were effective in easing the symptoms of IBS, especially Saccharomyces boulardii and Lactobacilli (among which Lactobacillus rhamnosus), synbiotics, psyllium, and some herbal medicinal products, primarily peppermint oil, the investigators wrote.

“Patients with common functional bowel disorders such as chronic idiopathic constipation and irritable bowel syndrome who cannot find benefit or have adverse effects with the use of traditional drug therapies, or do not want to use them, should be told that alternative medicines are available that may be effective,” lead author Dr. Diego Curro explained in a press release. “Also, patients with mild clinical forms of ulcerative colitis should be informed that they might use, with caution, an alternative probiotic treatment to prevent relapse.”

Additionally, for patients with functional constipation, the use of synbiotics and fiber seemed to be most beneficial. And for ulcerative colitis patients, using a probiotic combination of VSL#3 appeared to be effective in inducing remission in patients with mild to moderate cases. For these patients, it also seemed that Escherichia coli Nissle 1917 was as effective as mesalamine to continue remission.

“No definite conclusions can be drawn as to the efficacy of fiber and herbal medicinal products in irritable bowel disorder patients due to the low number of studies and the lack of randomized controlled trials that replicate the results obtained in the individual studies conducted so far,” the study authors concluded. “Thus, further, well designed studies are needed to address the real role of these therapeutic options in the management of both functional bowel disorders and irritable bowel disorders.”

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