Zen and the Art of IBS Management

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Zen and the Art of IBS ManagementMindfulness training was associated with significant reduction in irritable bowel syndrome severity and improvement in psychological factors.

Psychological interventions — including hypnotherapy, cognitive-behavioral therapy, and dynamic psychotherapy — have shown effectiveness in relieving symptoms of irritable bowel syndrome (IBS). In a recent controlled trial, researchers evaluated the benefits of another psychological treatment: mindfulness training, a form of meditation that employs concepts from several spiritually based meditation practices, including Buddhism. Individuals are taught to focus on the present moment, using breath or another object as a focal point, and to suspend thinking (including thoughts about the past and future, evaluations and interpretations of physical symptoms, and judgments about the significance of physical symptoms). The authors theorized that this process could reduce the tendency of IBS patients to overreact, or " catastrophize, " in response to physical sensations from the gut.

Ninety-seven women with IBS were randomized to attend either a mindfulness group or a support group, for 8 weekly 2-hour sessions and a single 4-hour retreat. Demographic characteristics were similar between the groups. Subjects were followed for 3 months after the interventions.

Improvements over baseline IBS severity scores were significantly greater for the mindfulness group than for the support group, at the end of treatment (26.4% vs. 6.2%) and at 3-month follow-up (38.2% vs. 11.8%). More individual symptoms were significantly improved in the mindfulness group than in the support group at 3-month follow-up (5 vs. 1). Scores for a variety of psychological factors — including anxiety, depression, somatization, and visceral sensitivity — were significantly improved at 3-month follow-up in the mindfulness group but not in the support group.

Comment: This controlled trial adds another psychological intervention, mindfulness training, to the armamentarium of effective therapies for IBS. Such training is safe and is a useful adjunct to traditional medical management.

—  K. Rex, MDPublished in Journal Watch Gastroenterology October 7, 2011

Citation(s):

Gaylord SA et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: Results of a randomized controlled trial. Am J Gastroenterol 2011 Sep; 106:1678.

Medline abstract (Free)

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