Mind/Body Treatment Options for IBS

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Of all of the various health conditions that afflict humans, none would appear to involve the interplay between the mind and the body as much as irritable bowel syndrome (IBS). This is not because IBS is "all in one's head," but rather because of the vast interconnectedness between our brain and our digestive system.

This brain-gut connection has prompted the use of various mind/body treatment options as potential treatments for IBS.

The following discussion of the mind/body relationship in IBS and the various kinds of mind/body treatment options will help you to decide whether such an option might be right for you.

The Mind/Body Split

With origins generally attributed to the philosopher Rene Descartes, modern medicine has used a "divide-and-conquer" strategy and has thus devised a split between the mind and the body. Although this approach is practical in that researchers and physicians can focus their efforts on specific body systems, a major drawback is a loss of focus on the fact that the body works as a whole. Stress-exacerbated medical conditions, such as IBS, that straddle the line between the mind and the body are not so easily understood or treated. Thus, they often fall in the cracks between medical disciplines.

The Mind/Body Connection in IBS

Luckily, more recent research efforts have attempted to better understand stress-related illnesses.

In the case of IBS, researchers have focused on the brain-gut axis, a back-and-forth communication system between our brain and our intestines. Within this axis, communication occurs through neurotransmitters, chemicals found throughout the central nervous system and the enteric nervous system, which is the part of the autonomic nervous system that handles digestion.

Impairments in the functioning of these systems are thought to contribute to the motility problems and visceral hypersensitivity experienced by IBS patients.

Although many factors, known and unknown, are thought to trigger IBS symptoms, one clear-cut culprit is stress. When we are stressed, neurochemical changes are seen throughout the central and enteric nervous systems, as part of our body's natural stress response. Scientists are studying why and how these particular neurochemical changes contribute to IBS.

To further complicate the problem, as many IBS patients will tell you, there is a "chicken and egg" aspect to IBS. Stress can exacerbate IBS symptoms, but IBS itself can be quite stressful! Mind/body treatment approaches become an attractive option as they help to increase the body's ability to handle psychosocial stressors.

Psychotherapy for IBS

Psychotherapy is the type of mind/body treatment that has received the most research attention. In general, studies have shown that the following types of psychotherapy are superior to standard medical care in reducing overall IBS symptoms.

Improvement of symptoms through the use of psychotherapy not only happens in the short-term, but appears to persist over time.

Although it is optimal to find a therapist who has experience treating IBS, this is not always possible. In this writer's opinion and experience, a therapist who specializes in anxiety can still be of help as long as they are open to understanding the specific challenges inherent in dealing with IBS. In any case, be sure that your therapist is properly licensed.

Alternative Treatments

The following treatments have been used successfully to treat many human ailments and have been studied for IBS. To date, research has not shown consistent benefits of acupuncture for IBS. On the other hand, biofeedback has shown some research support as a treatment for constipation, particularly that caused by a condition called dyssynergic defecation.

Mindfulness Meditation

Mindfulness meditation, a major component of mindfulness-based stress reduction (MBSR), would appear in theory to be a natural fit as a way to reduce IBS symptoms. Clinical studies on the use of MBSR for IBS have shown that it can be helpful in easing symptoms, particularly pain, and improving quality of life.

Movement Based Meditations

The following activities have long been practiced as a way to reduce stress and enhance health. Preliminary studies have shown some positive effects of yoga on IBS symptoms, but alas, formal research on the benefits of tai chi for IBS appears to be non-existent.

Sources:

Ford, A., et.al. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.

Lakhan, S. & Schofield, K. "Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis" PLoS One 2013 8:e71834.

Laird, K., et. al. "Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis" Clinical Gastroenterology and Hepatology 2015 Epub ahead of print.

Tanaka, Y., et.al. "Biopsychosocial Model of Irritable Bowel Syndrome" Journal of Neurogastroenterology and Motility 2011 17:131-139.

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