Holistic Treatment of Functional Irritable Bowel Syndrome with a Spotlight on Medical Acupuncture: A Narrative Clinical Update!

Abstract

Background: Irritable bowel syndrome (IBS) is a common recurrent functional disorder without organic pathology. IBS mostly afflicts females often presents in different forms with abdominal and extra-abdominal symptoms, and impacts quality of life of patients around the world. Objective: This update aims to critically describe the salient clinical features of IBS along with brief snapshots of complementary, conventional and integrative therapeutic approaches with a special focus on medical acupuncture. Methods: A selective e-searches of relevant literature were carried out using keywords and Boolean operators, and finally 65 articles were retained for this critical clinical update. Results: The main clinical manifestations of IBS include diarrhoea, constipation, abdominal pain, bloating and flatulence in the absence of “red flag” signs. Its several types (IBS-diarrhoea/constipation/mixed) affect approximately 15% to 40% of the general population. A variety of risk factors including gut-brain and biopsychosocial interactions contribute to the pathogenesis of this multifaceted gastrointestinal disorder that is reported to comorbid with other psychiatric disorders and physical diseases. A typical patient with IBS may require holistic customised intervention that will include complementary and integrative medicine modalities and conventional drug interventions with variable therapeutic results. Acupuncture is increasingly used globally and frequently combined with other Traditional Chinese Medicines (TCM) such as moxibustion, cupping therapy (Hijamah), medicinal herbs, mind-body-spirit therapies, and dietary modifications such as prebiotics and probiotics and life style changes for the successful management of patients with IBS. Conclusion: IBS is a multidimensional disorder and needs comprehensive clinical and diagnostic workup for making a precise diagnosis and personalised-treatment intervention. Medical acupuncture alone or combined with other holistic therapies produces good cost-effective results and improves quality of life of patients with IBS. This update calls for rigorous basic research to further explore the underlying pathophysiology of IBS along with mechanism of actions and effects of acupuncture in future.