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Psychological treatments work in irritable bowel syndrome

Sep 29, 2018

The Study

I was very interested to read a new study about the use of psychological therapies for irritable bowel syndrome. This was a meta-analysis, a study which compares results from dozens of high quality studies and attempts to draw meaningful conclusions by comparing them.

This study showed that there was a significant benefit from the use of psychological treatments in patients with IBS. It is similar in effect to the use of low dose anti-depressant medicines, which have also been shown to be successful.

Medicines for IBS

The findings certainly fit our practice. Whilst we often find tricyclic medicines (more commonly used for depression) work well for a wide range of bowel symptoms, many patients in our practice also do remarkably well following psychological treatments including gut-related self hypnosis. This is a treatment that was popularised by a professor in Manchester about 20 years ago but which remains underused by gastroenterologists. The idea is to help people reduce their pain or upset bowels by using simple but tried and tested approaches including breathing, visualisation and hypnosis. It is also successful for many other symptoms including ‘globus’ – a feeling of a lump in the throat and functional heartburn, where the patient feels as if they have acid reflux even when this does not actually exist. This particular symptom is also common but poorly recognised by doctors.

Psychological Treatments for IBS

Our experience of these treatments has been that in well selected patients, the improvements can be absolutely life-changing. We have seen people who have been to many other doctors and who have suffered for years. We confirm the diagnosis by non-invasive blood, breath and stool tests and abdominal ultrasound scanning or by endoscopy or colonoscopy. We then recommend a course of treatment which usually takes between 6 and 12 sessions to complete with a qualified psychologist. The actual sessions take place in central London and patients report that they find the whole experience calming and rejuvenating. They also tell us how much better they feel. We collect formal feedback in the form of standardised questionnaires before and after treatment which give hard evidence of the benefits that patients experience.

What is perhaps more important is that the effects of therapy tend to be long lasting. Our patients tell us that the benefits can last for years particularly if they continue to do the exercises after the sessions finish. In a way, psychological input should really be seen more as a training exercise. Once you have learnt the skills, you can incorporate them in your own life.

If you are suffering with IBS, you might want to consider psychological support therapies to help you. After all with this new study, there is strong medical evidence to support our existing experience that this approach can really make a difference for many people suffering with irritable bowel syndrome.