Heart Rate Variability—An Index of the Efficacy of Complementary Therapies in Irritable Bowel Syndrome: A Systematic Review

Abstract

Irritable bowel syndrome (IBS), as a functional and psychosomatic disease, reduces the quality of life and increases the risk of developing mental disorders. Deregulation of the autonomic nervous system (ANS) is one of the main causes of the disease. The objective of the present study was to identify the studies in which measurements of heart rate variability (HRV) were performed before and after therapeutic intervention, and to evaluate the effectiveness of IBS therapy in terms of a reduction of IBS symptoms and changes in autonomic tone. A systematic review of the literature was carried out in accordance with PRISMA standards. Six databases were searched for articles published before 2022: PubMed®, MEDLINE®, EBSCO, Cochrane, Scopus, and Web of Science. Inclusion criteria were experimental design, diagnosis of IBS (medical and/or diagnosis in accordance with the Rome Criteria), non-pharmacological intervention, and HRV measurement before and after the intervention. The quality of the studies was assessed by JBI Critical appraisal. In total, 455 studies were identified, of which,sixwere included in the review. Expected changes in HRV (increase in parasympathetic activity) were observed in four of the six studies (interventions studied: ear acupressure, transcutaneous auricular vagusnerve stimulation, cognitive behavioral therapy with relaxation elements, yoga). In the same studies, therapeutic interventions significantly reduced the symptoms of IBS. The present review indicated that interventions under investigation improve the efficiency of the ANS and reduce the symptoms of IBS. It is advisable to include HRV measurements as a measure of the effectiveness of interventions in IBS therapy, and to assess autonomic changes as a moderator of the effectiveness of IBS therapy.

Yoga and pain: A mind-body complex system

“…• diabetes (27) • inflammatory disorders (28,29) • immunological illnesses (30) Yoga's impact on pain is especially well documented and suitable for further examination given the thorough documentation of pain in patients and the reliability its associated biomarkers across the human system (31). The combination of interactions between pain responses and yoga practice create the potential need for a complex systems approach.…”

The Importance of Visceral Hypersensitivity in Irritable Bowel Syndrome—Plant Metabolites in IBS Treatment

“…The consequence of reducing the activity of the vagus nerve, for example, as a result of stress, is the increased secretion and permeability of the intestines and the intensification of inflammation in the intestines. In addition, pain receptors become more sensitive, which increases the perception of visceral pain in IBS [40]. Incorrect vagus nerve tension is described in IBS and inflammatory bowel disease (IBD), which is why it seems reasonable to state that VN (VNS) stimulation may become an effective therapy in the treatment of these diseases [30].…”

The Effects of Heart Rate Variability Biofeedback on Functional Gastrointestinal Disorders: A Scoping Review

“…Recently, there has been increasing evidence of a correlation between the prevalence of functional gut symptoms and an imbalance of autonomic nervous system activity, with greater relative sympathetic activity due to parasympathetic withdrawal (Aggarwal et al 1994;Bharucha et al 1993;Mróz, Czub, and Brytek-Matera 2022); (Jung-Ho et al 1999). This hypothesis is supported by the emerging efficacy of therapies proposed to enhance vagal tone, encompassing such diverse approaches as chewing gum, slow breathing exercises, moderate-pressure massage, or transcutaneous vagal electrical stimulation (Lunding et al 2008;Zhang et al 2023), accompanied by with evidence for improved antral, colonic and oesophageal motility and symptom reductions (Bonaz, Sinniger, and Pellissier 2016).…”