The placebo effect in irritable bowel syndrome trials: a meta‐analysis<sup>1</sup>

Patel, S. J.; Stason, William B.; Legedza, Anna; Ock, Sun Myeong; Kaptchuk, Ted J.; Conboy, Lisa; Canenguez, Katia M.; Park, J. K.; Kelly, Erik; Jacobson, Eric; Kerr, Catherine E.; Lembo, Anthony

doi:10.1111/j.1365-2982.2005.00650.x

Cited by 266 publications

(235 citation statements)

References 69 publications

Supporting

Mentioning

204

Contrasting

Unclassified

Order By: Relevance

“…37 In interpreting FGID trials, the placebo effect may play an important role. Placebo responses in trials of adults with IBS vary from 16.0% to 71.4%, 78 and high placebo rates up to 53% were reported in RCTs on children and adolescents. 41,43,79 High placebo responses may also display natural course of FGIDs with fluctuating symptoms.…”

Section: Alternative Medicinementioning

confidence: 99%

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.METHODS: Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.RESULTS: Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P , .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate. CONCLUSIONS:Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.

show abstract

Section: Alternative Medicinementioning

confidence: 99%

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The placebo response rate in IBS (based on 50 placebo controlled trials) ranged between 3% and 84% [38][39][40][41][42] . The reason for this wide range remains unclear, but the factors influencing the placebo response seem to be the duration of the study [43] , the number of follow up visits during the study [44] and the number of patients included in the study [26] . Enck & Klosterhalfen [26] reanalysed the data compiled by Spiller [43] with respect to the association between the amplitude of the placebo effect and the study duration.…”

Section: Placebo Effects In Patients With Functional Bowel Disordersmentioning

confidence: 99%

Placebo responses in patients with gastrointestinal disorders

Klosterhalfen¹,

Enck²

2007

WJG

View full text Add to dashboard Cite

Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including Pavlovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases (functional dyspepsia and irritable bowel syndrome) and organic gastrointestinal disease (duodenal ulcer and inflammatory bowel disease).

show abstract

“…The therapeutic approach is essentially focused on the symptoms as represented by anti-spasmodics for pain, laxatives or bulking agents, 5-HT4 agonists and guanylate cyclase-C agonist for intestinal transit regulation and anti-depressives/anxiolytics drugs. Placebo has a  40% efficacy in IBS patients (Patel, et al 2005) and pronounced placebo analgesia is coupled with prominent changes of brain activity in visceral pain matrix, as represented by the amygdala (Lu, et al 2010). Non-pharmacological therapies are of special interest.…”

Section: Introductionmentioning

confidence: 99%

The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis

Bonaz¹,

Pellissier²,

Sinniger³

et al. 2012

The Amygdala - A Discrete Multitasking Manager

View full text Add to dashboard Cite

show abstract

The placebo effect in irritable bowel syndrome trials: a meta‐analysis¹

Cited by 266 publications

References 69 publications

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Placebo responses in patients with gastrointestinal disorders

The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis

Contact Info

Product

Resources

About

The placebo effect in irritable bowel syndrome trials: a meta‐analysis1

Cited by 266 publications

References 69 publications

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Placebo responses in patients with gastrointestinal disorders

The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis

Contact Info

Product

Resources

About

The placebo effect in irritable bowel syndrome trials: a meta‐analysis¹