Effect of Brain-gut Behavioral Treatments on Abdominal Pain in Irritable Bowel Syndrome: Systematic Review and Network Meta-analysis.

abdominal pain cognitive behavior therapy evidence-based practice hypnosis

Journal

Gastroenterology
ISSN: 1528-0012
Titre abrégé: Gastroenterology
Pays: United States
ID NLM: 0374630

Informations de publication

Date de publication:
20 May 2024
Historique:
received: 21 12 2023
revised: 08 05 2024
accepted: 09 05 2024
medline: 23 5 2024
pubmed: 23 5 2024
entrez: 22 5 2024
Statut: aheadofprint

Résumé

Some brain-gut behavioral treatments (BGBTs) are beneficial for global symptoms in irritable bowel syndrome (IBS). US management guidelines suggest their use in patients with persistent abdominal pain but their specific effect on this symptom has not been assessed systematically. We searched the literature through 16 We identified 42 eligible RCTs, containing 5220 participants. After treatment completion, the BGBTs with the largest numbers of trials, and patients recruited, demonstrating efficacy for abdominal pain, specifically, included self-guided/minimal contact cognitive behavioral therapy (CBT) (RR = 0.71; 95% CI 0.54-0.95, P-score 0.58), face-to-face multicomponent behavioral therapy (RR = 0.72; 95% CI 0.54-0.97, P score 0.56), and face-to-face gut-directed hypnotherapy (RR = 0.77; 95% CI 0.61-0.96, P-score 0.49). Among trials recruiting only patients with refractory global IBS symptoms, group CBT was more efficacious than routine care for abdominal pain, but no other significant differences were detected. No trials were low risk of bias across all domains and there was evidence of funnel plot asymmetry. Several BGBTs, including self-guided/minimal contact CBT, face-to-face multicomponent behavioral therapy, and face-to-face gut-directed hypnotherapy may be efficacious for abdominal pain in IBS, although none were superior to another.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Some brain-gut behavioral treatments (BGBTs) are beneficial for global symptoms in irritable bowel syndrome (IBS). US management guidelines suggest their use in patients with persistent abdominal pain but their specific effect on this symptom has not been assessed systematically.
METHODS METHODS
We searched the literature through 16
RESULTS RESULTS
We identified 42 eligible RCTs, containing 5220 participants. After treatment completion, the BGBTs with the largest numbers of trials, and patients recruited, demonstrating efficacy for abdominal pain, specifically, included self-guided/minimal contact cognitive behavioral therapy (CBT) (RR = 0.71; 95% CI 0.54-0.95, P-score 0.58), face-to-face multicomponent behavioral therapy (RR = 0.72; 95% CI 0.54-0.97, P score 0.56), and face-to-face gut-directed hypnotherapy (RR = 0.77; 95% CI 0.61-0.96, P-score 0.49). Among trials recruiting only patients with refractory global IBS symptoms, group CBT was more efficacious than routine care for abdominal pain, but no other significant differences were detected. No trials were low risk of bias across all domains and there was evidence of funnel plot asymmetry.
CONCLUSIONS CONCLUSIONS
Several BGBTs, including self-guided/minimal contact CBT, face-to-face multicomponent behavioral therapy, and face-to-face gut-directed hypnotherapy may be efficacious for abdominal pain in IBS, although none were superior to another.

Identifiants

DOI: 10.1053/j.gastro.2024.05.010 PMID: 38777133
pubmed: 38777133
pii: S0016-5085(24)04932-1
doi: 10.1053/j.gastro.2024.05.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.

Auteurs

Vivek C Goodoory (VC)

Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Mais Khasawneh (M)

Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Elyse R Thakur (ER)

Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.

Hazel A Everitt (HA)

Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, UK.

Gregory D Gudleski (GD)

Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

Jeffrey M Lackner (JM)

Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

Rona Moss-Morris (R)

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Magnus Simren (M)

Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Dipesh H Vasant (DH)

Neurogastroenterology Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, UK.

Paul Moayyedi (P)

Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Christopher J Black (CJ)

Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Alexander C Ford (AC)

Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK. Electronic address: alexf12399@yahoo.com.

Classifications MeSH