Behavioral and non-pharmacological management of functional gastrointestinal disorders

Functional gastrointestinal disorders are prevalent and with the limited pharmacologic treatments available, interest has risen in pursuing complementary and alternative therapies as part of their management. In light of the role of the mind-gut axis in the pathophysiology of functional GI disorders, particularly irritable bowel syndrome, therapies have been deemed to affect this axis are a logical choice to be used in tandem with traditional pharmacologic interventions. In this chapter, we will focus on meta-analyses and systemic reviews that have evaluated alternative therapies, including psychological therapies, yoga, exercise, acupuncture, moxibustion and herbal remedies. Al though published reviews suggest that studies are likely to be biased and heterogeneity of patient populations and “control treatments, " studies have been supportive of a positive outcome with many of these approaches. Overall, complementary therapies appear to be safe and appropriate interventions as part of the management of patients with functional gastrointestinal disorders. Further studies are needed to determine the patient subgroups that may most benefit from these approaches and the specific components of these approaches that are beneficial.