Irritable bowel syndrome: Psychotherapy can improve GI symptoms and emotional health
Medical treatment alone has proven disappointing, but psychotherapeutic approaches are showing promise.
Combination therapy—medical management plus psychotherapy—may represent the future of IBS treatment (Table). This approach was examined recently in a randomized study of 24 IBS patients who received standard medical treatment alone or in combination with behavioral therapy. The behavioral component included patient education, helping patients shape a plausible model for their illness, progressive muscle relaxation, cognitive coping strategies, problem-solving education, and assertiveness and social skills training. All patients were treated in 10 individual therapy sessions of approximately 1 hour each by one of two psychotherapists across 10 weeks.
Compared with medical treatment alone, patients treated with combination therapy showed significantly improved GI symptoms (p < 0.001) and psychological symptoms (p = 0.01) in terms of both patient report and objective psychological measures. Outcomes are enhanced for patients with severe IBS, the investigators concluded, when behavioral therapy is added to thoughtful medical management.23
Related resource
- International Foundation for Functional Gastrointestinal Disorders. www.iffgd.org
Drug brand names
- Alosetron • Lotronex
- Tegaserod • Zelnorm
Disclosure
The author reports that he serves as a consultant to Novartis Pharmaceuticals Corp. He reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
