Mind-Body Treatment Options for IBS

There is a complex interplay between our minds and our bodies in irritable bowel syndrome (IBS). This is not because IBS is "all in your head," but rather because of the vast interconnectedness of our minds and emotions with our digestive systems.

A teenager talking with her therapist

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

The Mind/Body Connection in IBS

Research efforts have attempted to better understand how illnesses interplay with both our bodies and our minds.

In the case of IBS, researchers have focused on the brain-gut axis, a back-and-forth communication system between the brain and intestines. Within this axis, communication occurs through neurotransmitter chemicals and hormones found throughout the central nervous system (the brain and spinal cord), endocrine system, and the enteric nervous system (the gut) as 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 take place 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 can be an attractive option, as they help to increase the body's ability to handle physical and psychosocial stressors.

Mind/Body Therapies for IBS

Mind/body therapies can range from psychotherapy to meditation and biofeedback—anything that helps to bring awareness to how to manage the mind/body relationship found in IBS.

Psychotherapy

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. 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.

Biofeedback

Biofeedback has shown some research support as a treatment for constipation, especially for people who inadvertently tense up instead of relaxing when having a bowel movement.

Biofeedback has also been shown helpful for the pelvic floor disorder known as dyssynergic defecation.

Acupuncture

Acupuncture has had mixed research results for helping with IBS, but it has not been shown to cause harm. Acupuncture remains a viable alternative for people who want to try non-medicinal approaches to their IBS treatment.

Mindfulness Meditation

Mindfulness meditation, a major component of mindfulness-based stress reduction (MBSR), would appear 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.

The American College of Gastroenterology (ACG) recommends mindfulness-based practices in their 2021 treatment recommendations, even though the quality of evidence doesn't meet their usual standards. The ACG states that gut-directed psychotherapies (GDPs) can help people with IBS of all types, whether with constipation or diarrhea or both.

Interventions like MBSR are low-risk and have multiple long-term benefits on quality of life, even after the therapy is discontinued. Utilizing GDPs can help with some of the factors that negatively impact IBS, like the fear of symptoms, catastrophizing pain, and sensitivity to stress.

Movement-Based Meditation

Yoga and tai chi 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 formal research on the benefits of tai chi for IBS has not yet been published.

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