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IDDF2019-ABS-0189 Yoga-enhanced cognitive behavioural therapy (Y-CBT) versus rifamixin-probiotic sequential treatment for irritable bowel syndrome (IBS): a randomised clinical trial
  1. Debanjan Banerjee1,
  2. Sujata Bhatt2,
  3. Soumalyo Chatterjee1,
  4. Rajesh Sharma3
  1. 1National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
  2. 2St. Johns Medical College, Bangalore, India
  3. 3Bangalore Institute of Gastroenterology, India


Background Irritable bowel syndrome (IBS) is a common and disabling gastrointestinal disorder. It adds to immense morbidity. Recent theories implicate visceral hypersensitivity, stress and psycho-social factors in the causation of IBS. Kundalini Yoga affects the body homeostatis and cognitive behavioural therapy (CBT) when used in conjunction, reverse stress-induced underactivity of the parasympathetic nervous system. Rifamixin (a poorly absorbed antibiotic) and probiotics are common treatments of IBS used sequentially, altering gut flora. The primary objective here was to examine the effect of Yoga-enhanced CBT (Y-CBT) versus Rifamixin-probiotic treatment on patients with IBS.

Methods Sixty patients diagnosed as IBS entered a single-blind randomised controlled trial involving Y-CBT or rifamixin-probiotic sequential treatment for 12 weeks. The study was approved by the Institute Ethics Board. The Y-CBT group had 2 weekly sessions of (Kundalini Yoga + CBT) by trained professionals while the other group was treated with tablet Rifamixin 550 mg three times a day for 6 weeks followed by a probiotic capsule (containing B. infantis and L. rhamnosus) daily for next 6 weeks. Both groups received a total of three sessions of Mediterranean diet counselling for uniformity. The primary outcome was changed in gastronintestinal symptoms (IBS-SSS). Secondary measures were quality of life (IBS-QOL), depression (HAM-D), anxiety (HAM-A), perceived health status (PHSQ) and safety of interventions. Outcomes were assessed at 12 and 24 weeks, being blinded to allocation.

Results NO statistically significant difference was found between intervention groups with regard to IBS-SSS score at either 12 (Diff=34.2, 95%CI=-12.9, 76.6, P=0.121) or 24 weeks (Diff=32.9, 95%CI=-5.31, 70.14, P=0.071). Within group comparisons showed statistically significant effect for both the interventions. However, the Y-CBT group fared better in quality of life, anxiety and perceived health status. Drop-outs were more in the rifamixin-probiotic group (P=0.9). No serious adverse effects were reported.

Conclusions Yoga, being a traditional and simple intervention when used with CBT, can be as effective as the commonly used medicines in IBS. More research is warranted about their combined use.

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