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Treating the Mind Eases Irritable Bowel


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Hypnotherapy has also proven effective in small trials, although a recent review found insufficient evidence to recommend its widespread use, Hayee said.

In a condition with such a wide range of symptoms, treatment must be tailored to the individual patient, he said. "In general, people who are more open to the idea of therapy will do better," Hayee said.

IBS is a case of "brain-gut interaction," added Dr. Sita Chokhavatia, a professor of medicine in the gastroenterology department of Mount Sinai Medical Center in New York City, who specializes in treating the condition.

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"There is a 'big brain' in the skull and a 'little brain' in the enteric [intestinal] tract," she said. "Either you have too much information going up or too much information going down."

Treatment requires doctor-patient discussion in a psychiatric setting, Chokhavatia said. "You discuss it with patients -- not so much as a psychological disease per se but as a brain-gut reaction, so the patient can sense less pain."

The focus must be on the symptoms felt by a specific patient, she said. "Cognitive behavioral therapy has been used more in patients with constipation, where it has been shown to be successful in some studies," Chokhavatia said.

Talks between doctor and patient are used to establish levels of anxiety and stress felt by individuals, she said. If stress levels are high, hypnotherapy might be offered, "like people trying to stop smoking," Chokhavatia said.

The official government one-in-five estimate for IBS incidence might be low, she added, "Lots of people don't complain," Chokhavatia said. "They feel symptoms but don't come to the doctor."

Those who do seek help have a reasonable chance of getting it under control, in terms of gaining a better quality of life, she said.

More information

Causes, symptoms and treatments for IBS are described by the U.S. National Digestive Diseases Information Clearinghouse.

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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 5/25/2007

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SOURCES: Bu'Hussain Hayee, B.Sc., clinical research fellow, University Hospital London, England; Sita Chokhavatia, M.D., professor of medicine, Mount Sinai Medical Center, New York; May 26, 2007, British Medical Journal


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