Harnessing the Mind to Manage Irritable Bowel Syndrome

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For many patients, cognitive behavioral therapy, which uses the power of the mind to replace unhealthy beliefs and behaviors with healthy, positive ones, may be the answer. But, Lackner observed, very few facilities around the country specialize in this type of treatment.

Recognizing this, he and his colleagues set out to devise and test a treatment program that IBS patients could administer themselves.

Seventy-five women and men were divided into three groups. One group was placed on a "wait list" for 10 weeks while they monitored their symptoms. Another group received the standard treatment of 10 cognitive behavioral therapy sessions over 10 weeks. The third group had once-a-month therapy sessions over four months and practiced relaxation and problem-solving exercises at home.

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Not surprisingly, people on the wait list did not do well at all, while those in the 10- and four-week sessions showed significant improvement. "They said at the end of treatment they had achieved adequate relief from pain and adequate relief from bowel problems, and a significant proportion of patients said they improved their symptoms," Lackner explained.

While more studies are needed, the findings suggest that traditional and self-administered cognitive behavioral therapy both provide adequate relief and improve symptoms, said Lackner, who first reported the findings at large meeting of GI professionals.

Hypnosis may be another option. A pair of Swedish studies presented at that same meeting found that patients who received "gut-directed hypnotherapy" had significant improvement in symptoms compared with those who did not receive this intervention.

Hypnosis treatment has been reported to improve symptoms of the majority of treated IBS patients in all published studies, noted UNCs Palsson.

For patients who've tried the diet-and-drug regimen to no avail, Palsson said he would recommend either of these two psychological treatments.

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