Psychotherapy can give patients long-term relief from IBS symptoms

By Elizabeth Bacharach

“It comes on and I wish I could figure out how to control it, that I could stop it, but I can’t. I’ve tried,” said retired sales associate Cheryl Moran.

What is “it”?

Uncontrollable diarrhea.

“It” is a symptom of irritable bowel syndrome (IBS) — diarrhea along with abdominal pain, bloating and constipation on the long list of ailments that IBS patients like Moran face.

Sufferers often take various medications and use diet to control the discomfort.

But a new study in “Clinical Gastroenterology and Heptatology” suggests the possibility of easing these symptoms long-term through psychological therapies or psychotherapies.

The study aggregated data from 41 clinical trials that included 1,183 people assigned to psychotherapy and 1,107 to a control condition of treatment without psychotherapy. The researchers found that the individuals who received psychotherapy had a greater reduction in gastroenterological symptoms than 75 percent of those in the control group, not assigned to psychotherapy.

This study is novel because the impacts of psychotherapy were followed through and after treatment, according to Kelsey Laird, the lead study author and a doctoral candidate in clinical psychology at Vanderbilt University . The impacts “really don’t seem to decrease at all over a course of a 6 to12-month follow-up,” Laird said.

All of the studies assessed used surveys at the start, end and 6 to 12 months after treatment to determine the severity of remaining symptoms. While therapeutic responses varied, the three most frequently used were cognitive behavioral therapy, hypnosis and relaxation.

Moran was first diagnosed with IBS while participating in a different IBS study at Northwestern Memorial Hospital that required her to see a psychologist. She said she found “talking to someone” and the techniques discussed in session helpful, but Moran is not currently  undergoing any therapy.

Dr. Sarah Kinsinger said she frequently uses cognitive behavioral therapy to treat patients with IBS, as the syndrome is considered a “dysregulation between the brain and the gut.” Kinsinger is a psychologist at Northwestern Memorial Hospital and assistant professor at Northwestern’s Feinberg School of Medicine. She was not involved in the Vanderbilt study or the one involving Moran.

Although there is no definite cause for IBS, its severity is attributed to the influence of mental factors can have on the gastroenterological system.

Through cognitive behavioral therapy,  Kinsinger said, “a large majority of patients…have positive responses.”

Supporting  Kinsinger’s approaches and the Vanderbilt findings, Dr. Emanuelle Bellaguarda, a gastroenterologist at Northwestern Memorial Hospital, said that patients with IBS who receive psychotherapy are “much happier.”

“Their quality of life improves, they’re able to control their anxiety better, they’re able to control their symptoms better,” she said.

Moran said because of the effects of stress on her IBS, she spent a majority of the holiday season “in the bathroom.”

She said she has decided to return to therapy after reading the study’s findings,. “I really think that since I’ve been recommended a couple of times to go see someone to talk about [IBS], that I should do that, and it could help me kind of get things under control.”

Photo at top: IBS often makes people feel they need to be always near a bathroom. (Elizabeth Bacharach/MEDILL)