Some IBS symptoms may respond better to exercise than medication.

RODALE NEWS, EMMAUS, PA—When it comes to quick fixes, pharmaceuticals reign supreme. There's a tiny little pill to cure every ailment from baldness to athlete's foot, it seems, and whenever we go to a doctor's appointment, we expect to walk out with something in a bottle to fix our problems. But there are consequences to our drug dependency, namely antibiotic resistance, and doctors are getting frustrated that drugs are too often seen as the first line of defense, and that even more effective nondrug treatments are being ignored.

Case in point: A study published last week in the New England Journal of Medicine, funded by a drug company, concluded that two weeks of treatment with the company's antibiotic was effective in alleviating symptoms of irritable bowel syndrome, or IBS, a condition that affects roughly 15 percent of the public. The study received a fair amount of media attention and was hailed as "a long-awaited treatment for IBS sufferers."

But there's more to the story. "[The drug company] knew any antibiotic would work," says David Newman, MD, director of clinical research in the Department of Emergency Medicine at Mount Sinai School of Medicine. "Both of the antibiotic trials that they cite in their introduction worked, and worked even better than their drug." Newman, who has researched extensively the misuse of antibiotics, adds that people could wind up in even worse condition if they were to rely on antibiotics for IBS therapy. "These were short-course antibiotics in their study, and are very likely to do harm in the long run if taken chronically, which is what they're suggesting."

What's more, he adds, the drug company chose an illness that responds particularly well to the placebo effect, a point driven home by a study just published in the journal PLoS One by Ted Kaptchuk, associate professor of medicine at Harvard Medical School. In medical research, placebos—"fake" treatments, such as sugar pills, that contain no active ingredient—help researchers tell whether the simple act of treating a condition has an effect of its own. But prescribing them to patients usually involves deception, which, Kaptchuk notes in the introduction to his study, creates a certain ethical dilemma for doctors. So he tested whether IBS sufferers would improve with a placebo treatment, even knowing that they were getting a placebo. And it turns out, they did.

THE DETAILS: Kaptchuk and his fellow researchers divided a small group of 80 adults who had been diagnosed with IBS into two groups. One group was told it would be receiving a placebo, told it contained no drugs, and were given standard prescription medicine bottles clearly marked "placebo pills" with instructions to take two pills twice a day. The others were told they would not be receiving any treatments at all. Both groups met with either a doctor or a nurse practitioner at the beginning, middle, and end of the three-week study for a 15-minute conversation about symptoms, adverse effects, or any other questions the patients had. Also, during each visit, the patients filled out surveys related to their symptoms, whether their IBS was improving or not, and their general quality of life.

Despite knowing that they were taking a placebo, the placebo group saw significant improvements in symptoms and quality of life compared to the no-treatment group, with 59 percent of the placebo-takers reporting adequate relief of symptoms, compared to 35 percent for the no-treatment group. "Global" improvement scores were about 25 percent higher in the placebo group, and scores for relief of severe symptoms in the placebo group were double what they were in the no-treatment group.