Irritable Bowel Syndrome
IBS is a dysfunction of the bowel resulting in a variety of abdominal symptoms that may include constipation, diarrhea, cramps, bloating, as well as anxiety and fatigue. IBS is often reactive to stress and anxiety, and responds quite well to relaxation and guided imagery. In fact, the research into this common condition indicates that this mind/body approach is the treatment of choice, and works better than any medication. If you have IBS, we recommend that you use our "Guided Imagery for Self-Healing" book and 4 CD set to teach you the nine essential skills of using guided imagery to help stimulate healing from within. The book will explain the process, review the science behind it, and coach you through the common questions that people have, while the CD set guides you through the 9 essential guided imagery skills taught in the book. A quicker introduction, especially for people that don't prefer to read, is to use "Self-Healing with Guided Imagery", a 2 CD set featuring Dr. Andrew Weil. The first CD explains mind/body healing and guided imagery while the second teaches you the three most fundamental self-healing skills. A third alternative is to start with the "Stress Relief" or "Relaxing Into Healing" CDs to introduce you to relaxation and imagery.
RESEARCH
January 2006
Alternatively known as "spastic colon," irritable colon," or the highly imprecise "nervous stomach," Irritable Bowel Syndrome (IBS) is a functional disorder of the bowel.
IBS usually presents with patients reporting a change in the normal functioning of their bowels -- diarrhea, constipation, or alternating between the two. Because of the many pain receptors in the gut make it extremely sensitive to pain, patients often report discomfort. Other symptoms can include bloating, a sense of fullness, gas or flatulence. Symptoms are not confined to the gut. There can be nausea and reflux, non-cardiac-related chest pain, exhaustion, and depression. Quality of life is often low, with sleep, sexual functioning, and social life being affected. Other challenges to the IBS patient can exist when those patients have comorbid conditions such as thyroid disease, fibromyalgia, or Chronic Fatigue Syndrome (CFIDS).
Contrary to common opinion, diet is not a cause of IBS. The problem seems to be an errant communication between the central nervous system, the brain, and the bowel, causing the gut to be over-reactive, much like an over-vigilant immune system "causes" allergies. Diet can, however, trigger symptoms, and stress and emotions can adversely affect the gut (Whorwell, Houghton et al).
Incidence
IBS is more common than diabetes, asthma, heart disease, or hypertension (Adams, Benson), and it affects 20-22% of Americans at any one time, 60-65% of whom are women. Up to 70% of those who meet IBS diagnostic criteria do not seek medical attention (Zaman).
Diagnosis and Treatment
IBS is a diagnosis of exclusion, with medication being aimed at symptom management. Drugs include antispasmodics, antidiarrhetics, laxatives, bulking agents, and prokinetic agents (to move food quickly through the bowel). A patient exhibiting depression or having severe pain that hasn't responded to other treatment are often given SSRIs or low-dose tricyclic antidepressants. According to one expert, however, there is “little evidence” that medications are effective in treating IBS (Zaman). A new approach to treating IBS has to do with correcting bacterial overgrowth believed to be related to peristaltic problems in the small intestine. (Pimentel)
Mind-Body Approaches
Because of its well-established mind-body component, IBS is particularly responsive to mind-body modalities, and the literature supports this assertion. Relaxation (Keefer & Blanchard, 2001, 2002; Voirol, Hipolito, et al) and biofeedback (Leahy & Clayman) have shown success in improving symptoms and preventing relapse. One approach (relaxation, therapy, and medication) was effective in 66% of patients who had not responded to medication alone (Guthrie, Creed et al). A program of progressive muscle relaxation, thermal biofeedback, cognitive therapy, education had a 50% success rate, maintained four years later (Schwarz, Taylor et al). One meditation study reported that improvement in symptoms were maintained at one-year follow-up (Keefer). A 2005 review of fourteen hypnosis/IBS studies strongly reaffirms hypnosis' consistent efficacy (Tan, Hammond, Joseph). The power of placebo and positive suggestions and expectation are very interestingly illustrated in one study (Vase & Robinson et al).
Hypnosis has been effective even in refractory cases (Forbes & MacAulay et al.; Francis & Houghton; Galovski & Blanchard; Houghton & Heyman et al.), and in patients where psychotherapy has failed (Whorwell & Prior, et al). Significent improvement was shown when gut-directed suggestion was used (Forbes; Galovsky), even when the suggestions were audiotapes (Forbes). The Houghton-Heyman study results showed “profound” improvement in pain, bloating, and bowel habit). Gonsalkorale reported that not only symptoms, but quality of life, depression, anxiety and cognitive scores). This was also reported by Houghton, Heyman & Whorell; Blanchard & Radnitz, et al, ; and Read; it was echoed by patients who reported feeling more in control. Patients had fewer sick days and lower numbers of visits to the doctor than the control group (Houghton,1996).
Psychotherapy also proved superior to medication in 19 of 22 studies reviewed by Svelund (2002). Svelund, with co-author Sjodin, concluded from another study that patients only on medication actually deteriorated when compared with those receiving psychotherapy.
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