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Evidence summaries

Biofeedback for Treatment of Irritable Bowel Syndrome

There is insufficient evidence to assess whether biofeedback interventions are effective for controlling symptoms of IBS. Level of evidence: "D"

The quality of evidence is downgraded by study quality and imprecise results.

Summary

A Cochrane review [Abstract] 1 included 8 studies with a total of 300 subjects. Four trials assessed thermal biofeedback. One trial assessed rectosigmoidal biofeedback. Two trials assessed heart rate variability biofeedback. Two trials assessed electrocutaneous biofeedback.

The clinical benefit of biofeedback plus standard therapy compared to standard therapy alone was uncertain (RR 4.20, 95% CI 1.40 to 12.58). The same study also compared biofeedback plus standard therapy to sham biofeedback plus standard therapy. The clinical benefit in the biofeedback group was uncertain (RR 2.33, 95% CI 1.13 to 4.80; 1 study, 20 participants).The clinical benefit of heart rate biofeedback compared to hypnotherapy was uncertain when measured with the IBS severity scoring system (IBS-SSS) (MD 58.80, 95% CI 109.11 to 8.49; 1 study, 61 participants). Compared to counseling, the effect of heart rate biofeedback was unclear when measured with a composite symptom reduction score (MD 7.03, 95% CI 51.07 to 65.13; 1 study, 29 participants) and when evaluated for clinical response (50% improvement) (RR 1.09, 95% CI 0.48 to 2.45; 1 study, 29 participants).The clinical benefit of thermal biofeedback used in a multi-component psychological intervention (MCPI) compared to no treatment was uncertain when measured with a composite clinical symptom reduction score (MD 30.34, 95% CI 8.47 to 52.21; 3 studies, 101 participants), and when evaluated as clinical response (50% improvement) (RR 2.12, 95% CI 1.24 to 3.62; 3 studies, 101 participants). Compared to attention control, the effects of thermal biofeedback within an MCPI were unclear when measured with a composite clinical symptom reduction score (MD 4.02, 95% CI 21.41 to 29.45; 2 studies, 80 participants) and when evaluated as clinical response (50% improvement) (RR 1.10, 95% CI 0.72 to 1.69, 2 studies, 80 participants).

Clinical comments

Note

Date of latest search:

    References

    • Goldenberg JZ, Brignall M, Hamilton M et al. Biofeedback for treatment of irritable bowel syndrome. Cochrane Database Syst Rev 2019;(11):CD012530. [PubMed]

Primary/Secondary Keywords