Clinical research looks beyond the gut in IBS treatments

September 17, 2018

When your gastrointestinal (GI) system is upset, treating the GI system is an obvious place to start.  Sometimes that is enough, and other times it’s not.  Mounting clinical research highlights the role of the brain-gut axis in IBS.  It is important to address both the body and the mind in treatment strategies.  Multiple studies evaluating psychological approaches have demonstrated a reduction in symptoms and an improvement in quality of life.  The treatments that have shown the most promise are cognitive behavioral therapy, hypnotherapy, and mindfulness.

Cognitive behavioral therapy helps patients change thinking patterns and behaviors in a way that reduces physical and psychological distress.  These changes have been shown to lessen symptoms in IBS patients and have long-term positive effects.  During those sessions, patients learn how the stress response relates to the GI symptoms, understand the cognitive and behavioral responses correspond to symptoms, and how to change those responses to decrease symptoms.

Hypnotherapy teaches patients a series of exercises of gut-focused imagery over multiple sessions.  83% of patients from one study still felt the benefits of the treatment 1 – 5 years later.  More research is needed to understand how hypnotherapy works.  Researchers speculate that it normalizes pain processing, which tends to be over-active in IBS patients.  Interestingly, hypnotherapy has been shown to be as effective as the FODMAP diet for IBS.

Mindfulness helps patients bring awareness to the present moment and be nonjudgmental about GI symptoms when they arise.  In one study, patients showed a 38% reduction in symptoms after an 8 week mindfulness training course.

While there is much to learn about these treatment options and which patients derive the most benefit, it is clear that there is benefit to IBS patients in treating the mind and body simultaneously.  To reduce symptoms, pay attention to how you feel emotionally as well as physically.  Do things that make you happy.  Build into your day and week activities that bring a since of calmness and peacefulness.

If you’re interested in the scientific details, check out the following scholarly journal articles.

Ballou S, Keefer L. Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases. Clin Transl Gastroenterol. 2017 Jan 19;8(1):e214.

Farhadi A, Banton D, Keefer L. Connecting Our Gut Feeling and How Our Gut Feels: The Role of Well-being Attributes in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018 Apr 30;24(2):289-298.

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