How talking therapy can soothe IBS

Treatments that focus on the mind may ease irritable bowel syndrome.

Of all the lifestyle illnesses peculiar to a generation that is stressed-out, tired-out and flaked-out, one has persistently remained an enigma to the medical profession: irritable bowel syndrome.
IBS is thought to affect around eight million Britons, though with no confirmed cause, diagnosis is tricky and treatment of the debilitating symptoms – which include abdominal bloating and cramping, diarrhoea and constipation – even more difficult. But as researchers begin to unravel the complexities of the condition, it emerges that therapies focusing on the mind, not the body, are most effective.
A survey by Bu’Hussain Hayee, a clinical research fellow at University College Hospital, and Dr Ian Forgacs, a consultant gastroenterologist at King’s College Hospital, London, published in the BMJ recently concluded that approaches such as hypnotherapy, cognitive behavioural therapy (CBT) and antidepressant drugs could be most helpful.
According to Forgacs, IBS is a “complex mix of physical and emotional factors and people suffer for a variety of different reasons”. Typically, it is diagnosed when X-rays, blood tests, examination of the stool and other tests do not reveal any abnormality; patients are known to be more likely to suffer depression and somatisation (the conversion of mental problems into physical complaints). Yet despite the variation in underlying causes, mind-based treatments seem to help.
Many sufferers report that their IBS starts during or after a stressful period in their lives such as a divorce, sudden unemployment or a bereavement.

In other cases, it is linked to bacterial gastroenteritis – usually food poisoning – or a food intolerance. But so strong are the psychological underpinnings of the illness that Dr Nick Read, medical adviser to the IBS Network, says “it develops in patients with these problems only if something stressful is happening at the same time”. Read adds that the medical profession is increasingly prone to believe that “IBS is a gut reaction to emotional upheaval or upset”.
What is of interest to many researchers, including Forgacs, is how and why this somatisation takes place. One popular, but controversial, theory is that the human body has a second – hidden but powerful – brain known as the enteric nervous system that controls gut functions and reactions. “Certainly, the human body does seem to have both a conscious brain and a subconscious one that controls bodily functions such as hunger,” Forgacs says. “There are so many interactions between the two and it could explain why the majority of patients with anxiety problems will have alterations of gut function too.”

Source - Times

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