Systematic review with meta‐analysis: Stress‐management interventions for patients with irritable bowel syndrome

Author:

Horn Anna1ORCID,Stangl Stephanie1,Parisi Sandra12,Bauer Nina3,Roll Julia14,Löffler Claudia5,Gágyor Ildikó2,Haas Kirsten1,Heuschmann Peter U.16,Langhorst Jost37,Keil Thomas148

Affiliation:

1. Institute of Clinical Epidemiology and Biometry Julius Maximilians University of Würzburg Würzburg Germany

2. Department of General Practice University Hospital of Würzburg Würzburg Germany

3. Department for Internal and Integrative Medicine Sozialstiftung Bamberg Hospital Bamberg Germany

4. State Institute of Health Bavarian Health and Food Safety Authority Erlangen Germany

5. Department of Internal Medicine II University Hospital of Würzburg Würzburg Germany

6. Clinical Trial Centre Würzburg University Hospital of Würzburg Würzburg Germany

7. Department for Integrative Medicine University of Duisburg‐Essen Medical Faculty Bamberg Germany

8. Institute of Social Medicine, Epidemiology and Health Economics Charité—Universitätsmedizin Berlin Berlin Germany

Abstract

AbstractIrritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder of unknown pathological origin that is associated with psychological distress and reduced health‐related quality of life (HRQoL). We investigated the effects of stress‐management for adults with IBS on typical symptoms, HRQoL and mental health. With predefined criteria (patients: adults with IBS; intervention: stress‐management; control: care as usual or waitlist; outcome: patient‐relevant; study‐type: controlled trials), we registered the study with PROSPERO (168030) and searched the main medical databases. Two researchers independently reviewed the publications and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network checklist. We performed meta‐analysis with homogeneous trials of acceptable quality. After screening 6656 publications, ten suitable randomized trials of acceptable (n = 5) or low methodological quality (n = 5) involving 587 patients were identified. Our meta‐analysis showed no effect of stress‐management on IBS severity 1–2 months after the intervention (Hedges' g = −0.23, 95%‐CI = −0.84 to −0.38, I2 = 86.1%), and after 3–12 months (Hedges' g = −0.77, 95%‐CI = −1.77 to −0.23, I2 = 93.3%). One trial found a short‐term reduction of symptoms, and one trial found symptom relief in the long‐term (at 6 months). One of two studies that examined HRQoL found an improvement (after 2 months). One of two studies that examined depression and anxiety found a reduction of these symptoms (after 3 weeks). Stress‐management may be beneficial for patients with IBS regarding the short‐term reduction of bowel and mental health symptoms, whereas long‐term benefits are unclear. Good quality RCTs with more than 6 months follow‐up are needed.

Publisher

Wiley

Subject

Psychiatry and Mental health,Applied Psychology,Clinical Psychology,General Medicine

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