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Is yoga effective for irritable bowel syndrome as compared to usual care?
Date of publication of the systematic review: April 2016
Design
Systematic review of 6 randomized controlled trials (RCTs).
Participants
273 adults and adolescents with irritable bowel syndrome (IBS) who were diagnosed by Rome criteria or any other clinician-based diagnostic criterion (mean age range: 14.2 to 44.1 years, 28.6% male). Participants with comorbid physical or mental disorders were eligible for inclusion.
Intervention
Yoga interventions including at least 1 of the following were eligible: physical activity, breath control, meditation, and/or lifestyle advice based on yoga theory and/or traditional yoga practices. The reviewers did not state the yoga tradition, length, frequency, or duration of the intervention.
Comparator
Comparison: Yoga versus usual care.
Major Outcomes
Outcome 1: Post-treatment improvement in the severity of IBS symptoms as measured by patient-rated scales;
Outcome 2: Post-treatment pain or disability as measured by Numeric Rating Scale (NRS);
Outcome 3: Post-treatment improvement in quality of life or well-being as measured by Health-Related Quality of Life-Short Form-36, the IBS Quality of Life questionnaire or Functional Disability Index.
Outcome 2: Post-treatment pain or disability as measured by Numeric Rating Scale (NRS);
Outcome 3: Post-treatment improvement in quality of life or well-being as measured by Health-Related Quality of Life-Short Form-36, the IBS Quality of Life questionnaire or Functional Disability Index.
Settings
These studies were concluded in outpatient settings.
Comparison Yoga versus usual care
Main Results
Compared to usual care, yoga showed significant improvement in reducing severity of IBS symptoms as measured by patient-rated scales. Yoga also improved patients’ quality of life as measured by Health-Related Quality of Life-Short Form-36, the IBS Quality of Life questionnaire or Functional Disability Index. However, yoga did not show significant improvement in reducing pain or disability among IBS patients.
| Outcomes | No. of studies (Total no. of participants) | Mean score/ No. of participants | Heterogeneity test (I2) | Pooled MD (95% CI) | Overall quality of evidence* | |
| Intervention | Comparator | |||||
| 1 | 3 (201) | Not reported/119 | Not reported/79 | Not reported | Not reported | Low |
| 2 | 3 (201) | Not reported/119 | Not reported/79 | Not reported | Not reported | Low |
| 3 | 3 (201) | Not reported/119 | Not reported/79 | Not reported | Not reported | Low |
Comparison Yoga versus usual care
Main Results
Compared to usual care, yoga showed significant improvement in reducing severity of IBS symptoms as measured by patient-rated scales. Yoga also improved patients’ quality of life as measured by Health-Related Quality of Life-Short Form-36, the IBS Quality of Life questionnaire or Functional Disability Index. However, yoga did not show significant improvement in reducing pain or disability among IBS patients.
Comparison: Yoga versus usual care among patients with IBS
| Outcomes | 1 | 2 | 3 | |
|---|---|---|---|---|
| No. of studies (Total no. of participants) | 3 (201) | 3 (201) | 3 (201) | |
| Mean score/ No. of participants | Intervention | Not reported/119 | Not reported/119 | Not reported/119 |
| Comparator | Not reported/79 | Not reported/79 | Not reported/79 | |
| Pooled MD (95% CI) | Not reported | Not reported | Not reported | |
| Overall quality of evidence* | Low | Low | Low | |
Keys: MD = mean difference, CI = confidence interval.
Conclusion
Benefits
Compared to usual care, yoga showed significant improvement in reducing severity of IBS symptoms and in improving quality of life among IBS patients. However, yoga did not provide significant reduction in pain or disability.
For all outcomes, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events related to yoga were reported in the included studies.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/27112106The synopsis is based on the following article:
Schumann D, Anheyer D, Lauche R, Dobos G, Langhorst J, Cramer H. Effect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review. Clinical Gastroenterology and Hepatology. 2016 Apr 22.
Schumann D, Anheyer D, Lauche R, Dobos G, Langhorst J, Cramer H. Effect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review. Clinical Gastroenterology and Hepatology. 2016 Apr 22.
* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.
Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.
Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.
