Research: KEARNEY and BROWN-CHANG,

Listed in Issue 165

Abstract

KEARNEY and BROWN-CHANG, Gastroenterology Section, University of Washington School of Medicine, VA Puget Sound Health Care System, Seattle, WA 98108, USA. kearney@u.washington.edu review (101 references) the effects of various psychological mind-body interventions for IBS.

Background

Standard treatment for IBS focuses on the management or alleviation of the predominant gastrointestinal presenting symptoms, such as diarrhoea or constipation, often using pharmacological therapy.

Methodology

For many patients, this approach is unsatisfactory, and patients frequently seek the advice of complementary and alternative medicine (CAM) practitioners in order to explore other treatment options. CAM practices include a broad range of modalities, and mind-body interventions hold particular promise as treatment modalities for IBS because psychological factors could have an important role in IBS symptomatology and quality of life.

Results

Psychological stressors are postulated to result in gastrointestinal symptoms through alteration of intestinal function mediated by the autonomic nervous system, hypothalamic-pituitary-adrenal axis and immune system. Hypnotherapy has the strongest supportive evidence as a beneficial mind-body intervention for IBS. Clinical studies of hypnotherapy have uniformly shown improvement of gastrointestinal symptoms, anxiety, depression and quality of life in patients with IBS. Mindfulness meditation remains unstudied for IBS, but is theoretically attractive as a stress-reduction technique. There is a suggestion that relaxation therapy or multimodal therapy (a combination of relaxation therapy, education and psychotherapy) is beneficial for IBS.

Conclusion

The most generally accepted psychological mind-body intervention is cognitive behavioural therapy, and clinical trials support the beneficial effects of cognitive behavioural therapy in patients with IBS. [References: 101]

References

Kearney DJ and Brown-Chang J. Complementary and alternative medicine for IBS in adults: mind-body interventions. [Review] [101 refs]. Nature Clinical Practice Gastroenterology & Hepatology. 5(11): 624-36. Nov 2008.

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