Irritable bowel syndrome: are complementary and alternative medicine treatments useful?

Irritable bowel syndrome (IBS) is a complex multifactorial disorder resulting from brain-gut dysregulation.1 It has elements of motor and sensory gut abnormalities that might be related to postinflammatory, genetic, and psychological causes. Irritable bowel syndrome results in various functional gastrointestinal symptoms such as recurrent abdominal pain, changes in bowel habits, diarrhea or constipation, bloating, and bowel urgency. It is a clinical syndrome without evidence of structural abnormalities. The diagnosis can be made using the Rome III criteria in the absence of “red flag” symptoms.2 Irritable bowel syndrome is classified by constipationpredominant symptoms, diarrhea-predominant symptoms, or alternating symptoms of diarrhea and constipation. The hallmark symptom is recurrent abdominal pain that improves with defecation.2 With a prevalence of 10% to 15% in the general population, IBS is one of the most common functional gastrointestinal disorders worldwide. Most people with IBS do not seek medical care; however, those who do have reduced quality of life, have increased absenteeism from work, and utilize health services at higher rates,3 which has substantial direct and indirect costs for the health system. In the United States, IBS resulted in more than 3.6 million physician office visits in 1998 and cost about $1.7 billion (US) in 2000.4