Abstract
Abstract Current allopathic treatments for irritable bowel syndrome (IBS) are of limited efficacy. Complementary therapies, such as acupuncture, moxibustion, massage and cupping, including hijama, are frequently promoted in the lay press as effective alternatives. In addition, a number of clinical trials have been published, especially with regards to acupuncture, which indicate that they do have therapeutic benefits. This review considers the difficulties associated with formulating randomised controlled trials of such therapies and indicates approaches which may allow objective assessments of their effectiveness.
Highlights
Randomised control double blind studies are generally accepted as the gold standard for assessment of therapeutic interventions as they provide both more control for bias as well as sound evidence of cause and effect
They should overcome issues related to the complexity of irritable bowel syndrome (IBS) and the difficulties associated with its definition as well as the nature of meridian therapies
In a German randomised controlled study of 141 patients where sham cupping was described to participants as “gentle cupping” compared to “traditional cupping” both groups experienced significant benefit compared to those receiving conventional therapy
Summary
Randomised control double blind studies are generally accepted as the gold standard for assessment of therapeutic interventions as they provide both more control for bias as well as sound evidence of cause and effect. Such studies should be the most suitable ones to measure the effect of traditional techniques, such as acupuncture or moxibustion. Patients in an IBS trial need a clear and certain diagnosis. They should be representative of the population from which they are drawn, and ideally include ethnic minorities. The issue of bias can be addressed through randomisation and blinding of external assessors
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