• Rafael Leite Pacheco, Arnaldo Roizenblatt, GóisAécio Flávio Teixeira deAFT0000-0003-0217-1463MD, MSc, PhD. Cardiologist and Adjunct Professor, Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Carolina de Oliveira Cruz Latorraca, Carolina Frade Magalhães Girardin Pimentel Mota, and Rachel Riera.
• MD. Postgraduate Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
• Sao Paulo Med J. 2019 May 8; 137 (1): 829182-91.

BackgroundIrritable bowel syndrome (IBS) is a clinical disorder associated with high socioeconomic burden. Despite its importance, management of IBS remains difficult and several interventions have been hypothesized as beneficial for this condition. This study identified and summarized all Cochrane systematic reviews (SRs) about the effects of interventions for managing IBS patients.Design And SettingReview of systematic reviews, carried out in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP).MethodsReview of Cochrane SRs addressing interventions for IBS.ResultsWe included six SRs assessing acupuncture, bulking agents, antispasmodics, antidepressants, herbal medicines, homeopathy, hypnotherapy and psychological therapy for IBS. The certainty of evidence ranged from unknown to moderate, mainly due to imprecision in the estimates and high risk of bias from the primary studies included. There was moderate certainty of evidence that acupuncture had no important benefit regarding improvement of symptoms and quality of life, compared with sham acupuncture. There was also very low certainty of evidence that homeopathic asafoetida, used alone or in association with nux, was better than placebo regarding self-reported overall improvement.ConclusionThere was moderate certainty of evidence that acupuncture had no important benefit regarding improvement of symptoms and quality of life. Further well-designed and well-conducted randomized clinical trials are needed in order to reduce the uncertainties regarding the most commonly used interventions for patients with IBS.

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