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Irritable bowel syndrome - Management
What treatments are not recommended?

  • The use of aloe vera is not recommended for the treatment of irritable bowel syndrome (IBS).
  • The use of acupuncture or reflexology should not be encouraged for the treatment of IBS.
  • There are too many uncertainties regarding type and dose of herbal medicines to make a recommendation for practice.
    • CKS advises that the use of herbal medicines should not be encouraged in people with IBS.
  • There is insufficient evidence to make a recommendation on prebiotics.
Basis for recommendation

Basis for not recommending aloe vera

  • There is evidence from one study that aloe vera has no significant effect on the global or individual symptoms of irritable bowel syndrome (IBS) or on quality of life, compared with placebo.
  • There is limited evidence of adverse effects associated with oral aloe preparations.

Basis for not encouraging acupuncture or reflexology

  • Very limited evidence from one small study in 34 people suggests that reflexology has no effect on pain, bowel function, or bloating in people with IBS.
  • There is some evidence from several small studies that shows no significant effect of acupuncture on IBS global symptoms, pain, or quality of life.
  • There is evidence of potentially serious adverse effects (e.g. pneumothorax) associated with acupuncture.

Basis for herbal medicines

  • Good quality evidence on the use of herbal medicines is limited and inconsistent. The available evidence generally shows no significant effect of herbal medicines on symptoms of IBS.
  • CKS does not recommend the use of herbal preparations as these preparations are unlicensed and unregulated. The quality and safety of these preparations cannot therefore be guaranteed.

Basis for prebiotics

  • Prebiotics are non-digestible food ingredients that affect the host by selectively targeting growth and/or activity of one or more species of bacteria in the colon.
  • These recommendations are based on the consensus of the Guideline Development Group (GDG) [National Collaborating Centre for Nursing and Supportive Care, 2008].
    • The GDG felt that there was only a moderate amount of weak evidence that showed no significant difference with regard to global symptoms or bloating between people given a prebiotic and people given a placebo.
    • The GDG agreed that there was insufficient evidence to make a recommendation on prebiotics.

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