When standard lifestyle adjustments such as dietary changes and drug therapy don’t provide relief from the pain, bloating and other unpleasant gastrointestinal symptoms of irritable bowel syndrome, patients may want to try a different approach.
Recent studies show that using one's own thoughts, as taught in cognitive behavioral therapy, may help ease symptoms. Using hypnosis to visualize the pain and imagine it seeping away can be a powerful treatment strategy, too.
People with IBS experience chronic or recurrent constipation or diarrhea—or bouts of both. While the exact cause of the condition isn't known, symptoms seem to result from a disturbance in the interaction of the gut, brain and nervous system.
Doctors generally advise patients to avoid certain foods and may prescribe different medications. But these approaches don't always provide adequate relief.
Jeffrey M. Lackner, PsyD, assistant professor of medicine at the University at Buffalo School of Medicine & Biomedical Sciences is a behavioral medicine specialist whose research focuses on gastrointestinal disorders, particularly IBS.
For many patients, cognitive behavioral therapy, which uses the pov/er of the mind to replace unhealthy beliefs and behaviors with healthy, positive ones, may be the answer. He and his colleagues set out to devise and test a treatment program that IBS patients could administer themselves.
THE COGNITIVE BEHAVIORAL STUDY
Seventy-five women and men were divided into three groups. One group was placed on a "waitlist" for 10 weeks while they monitored their symptoms. Another group received the standard treatment of 10 cognitive behavioral therapy sessions over weekly. The third group had once-a-month therapy sessions over four months and practiced relaxation and problem-solving exercises at home.
Not surprisingly, people on the waitlist did not do well at all, while those in the weekly and monthly 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," Dr. Lackner explained.
THE HYPNOSIS STUDY
Hypnosis may be another option. A pair of Swedish studies 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 Dr. Olafur S. Palsson.
RECOMMENDATIONS
For patients who have tried the diet-and-drug regimen to no avail, Dr. Palsson said he would recommend either of these two psychological treatments.
"If a patient's main goal is substantial relief of bowel symptoms, hypnosis is probably the better choice," he said.
On the other hand, he added, if a patient wants to cope better with the illness or improve mental well-being, then cognitive behavioral therapy is equally good or perhaps even the better treatment option.
