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Patients With IBS Report Similar Satisfaction for Drug Treatments, Alternative Therapies: Presented at DDW

By Mary Beth Nierengarten

CHICAGO -- June 5, 2009 -- Patients with irritable bowel syndrome (IBS) who use alternative therapies are more likely to be women, have long-standing IBS symptoms, alternating diarrhoea and constipation, bloating, and anxiety/depression but are not more likely to be more satisfied with these therapies than with drug treatments, reported investigators in a study presented here at Digestive Disease Week (DDW) 2009.

In a study conducted to assess the frequency of use and satisfaction with alternative therapies in IBS patients, Hervé Hagege, MD, Centre Hospitalier Intercommunal de Créteil, Créteil Cedex, France, and colleagues used a questionnaire to collect data from 644 gastroenterologists in France on symptoms and drug treatment or alternative therapy on their IBS patients.

A questionnaire was also sent to patients about the quality of information they received regarding IBS from their gastroenterologist and their level of satisfaction with treatment.

According to Dr. Hagege, the investigators conducted the study because the contribution of alternative therapies to treat IBS remains unknown, and, despite various therapeutic approaches to treatment, long-term outcomes are often disappointing.

The investigators collected and analysed data from 2,933 pairs of gastroenterologist-patient questionnaires. Results of the study were presented on June 2.

Most of the study patients were women (72%), had an average age of 52 years, and had suffered from IBS for 10 years. Overall, most patients (82%) were satisfied with the level of information they received on IBS.

The most commonly reported symptoms were pain (91%), bloating (62%), constipation (37%), and epigastric pain (22%).

The most common alternative therapies used by patients included probiotics (n = 976), homeopathy (n = 496), osteopathy (n = 382), relaxation (n = 367), herbs (n = 345), acupuncture (n = 344), psychotherapy (n = 339), hydrotherapy (n = 232), sophrology (n = 207), and hypnotherapy (n = 160).

Multivariate analysis found that factors significantly associated with alternative therapy included being a female (P < .001), duration of IBS symptoms (P < .0001), having alternating diarrhoea and constipation (P < .0001), bloating (P < .01), and anxiety/depression (P < .0001).

No significant difference was found in level of patient satisfaction with these alternative therapies over regular treatments. Based on a visual analogue scale (VAS) ranging from 1 to 10, the study found that patient satisfaction with traditional drug treatments was 4.9. Satisfaction with alternative therapies was 4.4 for probiotics, followed by homeopathy, osteopathy, relaxation, herbs, acupuncture, psychotherapy, hydrotherapy, sophrology, and hypnotherapy.

The study also found that patients used alternative therapies more frequently than recognised by their gastroenterologists, with 20% of patients reporting alternative therapy use in the previous 12 months versus 13% reported by gastroenterologists (P < .0001).

According to Dr. Hagege, the results of the analysis suggest that gastroenterologists underestimate the use of alternative therapies by their patients.

[Presentation title: Alternative Therapies in Irritable Bowel Syndrome: Results of a Prospective Study, ENTERAL Study. Abstract T1022]

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