Romanian Guidelines for Nonpharmacological Therapy of IBS.

BACKGROUND AND AIMS: The nonpharmacological therapy in irritable bowel syndrome (IBS) is expanding rapidly. Practitioners and medical educators need to be aware of progress and changes in knowledge of this topic. The Romanian Society of Neurogastroenterology aimed to create guidelines based on best evidence on the use of nonpharmacological therapy in IBS. METHODS: A group of experts was constituted. This was divided in eleven subgroups dedicated to eleven categories of nonpharmacological therapy. The subgroups searched the literature and formulated statements and recommendations. These were submitted to vote in order to obtain consensus. RESULTS: The outcome of this activity is represented by the guidelines of the Romanian Society of Neurogastroenterology, presented in this paper. The recommendations are seen as complementary to the pharmacological therapy and are not intended to recommend avoiding pharmacological drugs. CONCLUSIONS: These guidelines were elaborated by a Delphi process and represent a useful tool for physicians managing patients with IBS.

The use of complementary and alternative therapies and of psychotherapy by Romanian patients with irritable bowel syndrome.

UNLABELLED: Irritable bowel syndrome (IBS) is an invalidating condition, lacking a perfect therapy. Therefore, many patients use also complementary and alternative therapies (CAT) or psychotherapy (PT). There are no data on the use of CAT and PT in IBS in our area. We looked for this until uncovered aspect of IBS management in Romania. MATERIAL AND METHODS: 250 consecutive patients with IBS (142 F/108M, aged 49 +/- 12 years) referred to a tertiary gastroenterological center were questioned about the use of CAT and PT using a structured specially developed questionnaire. All of the patients accepted to answer the questionnaire after careful instruction. RESULTS: 162 out of 250 pts (64%) admitted to have used one or more CAT, usually together with pharmacological prescriptions. Among CAT users, 32 patients (20%) used only CAT and not allopathic drugs. CAT used were: homeopathy 13%, herbal therapy 72%, acupuncture 3%, bioenergetic resonance 11%, others 13%. Probiotics were used by 30%. Users were mainly females of lower educational levels. Psychotherapy was used by 30 pts (12%). 25 (10%) used CBT, 15 (6%) used relaxation therapy. CONCLUSION: The majority of IBS pts. in our area use CAT usually in association with allopathic therapy. The most frequently used are herbal prescriptions followed by probiotics. PT less frequently used in our IBS patients.