It’s a condition that disproportionately affects women and is characterized by chronic abdominal pain, constipation, and diarrhea.
Irritable bowel syndrome (IBS) is also one of the most common conditions that physicians treat. Now, a recent clinical trial has concluded that a new mind-based, at-home treatment may offer significant relief.
Between 10 and 15 percent of adults worldwide experience the pain, frustration, and embarrassment of IBS symptoms.
It’s a chronic, often lifelong, disorder. Besides the personal cost, IBS also brings significant economic burdens.
According to a paper by Dr. Anthony J. Lembo, director of the GI Motility Laboratory at Beth Israel Deaconess Medical Center in Massachusetts, the estimated annual cost of IBS is around $30 billion in the United States.
A game-changing treatment
The latest medical trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health.
Researchers at the University of Buffalo, Northwestern University, and New York University pooled their expertise and talent to both develop and test the innovative, mind-based strategy to treat IBS.
Researchers said the participants experiencing the most severe and persistent IBS symptoms successfully learned to control their symptoms with minimal interaction with clinical professionals.
“This is a novel, game-changing treatment approach for a public health problem that has real personal and economic costs, and for which there are few medical treatments for the full range of symptoms,” said Jeffrey Lackner, PsyD, lead author and professor in the department of medicine in the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo and director of the school’s Behavioral Medicine Clinic, in a press release.
Participants either had 10 clinic visits or four visits combined with self-study materials.
They were taught cognitive behavioral therapy (CBT) techniques to take control of their gastrointestinal symptoms.
The CBT treatment consisted of information on brain-gut interactions, self-monitoring of symptoms, triggers and consequences, worry control, muscle relaxation, and flexible problem-solving.
“The treatment is based on cutting-edge research that shows that brain-gut connection is a two-way street. Our research shows that patients can learn ways to recalibrate these brain-gut interactions in a way that brings them significant symptom improvement that has eluded them through medical treatments,” Lackner explained.
Getting to the gut issues
Psychological stress is widely accepted as an important factor contributing to IBS.
“This study embraces one of the most important notions underlying the causes of IBS — the brain-gut connection. CBT, if adhered to and utilized properly, can be safer and more effective in providing relief of symptoms,” said Dr. Vijaya Rao, an assistant professor of medicine in the section of gastroenterology, hepatology, and nutrition at the University of Chicago Medicine, who wasn’t involved in the study.
“Drug-based therapy may be helpful at times, but it’s imperfect, as medications have their own side effects, which can be troubling to patients. If we are able to make programs like the study describes widely available to patients, this could revolutionize the treatment of IBS,” she said.
Two weeks after home-based behavioral treatment ended, 61 percent of trial participants reported significant improvement, compared to 55 percent who received clinic-based treatment and 43 percent who received only patient education.
The researchers said the benefits persisted for as long as six months after CBT treatment ended.
“One measure of the strength of clinical trial findings is when two data sources report similar data about an endpoint. In our study, there was striking similarity between the treatment response reported by patients and ‘blind’ assessors. This pattern of agreement from patients and physicians shows that we see very real, substantial and enduring improvement in GI symptoms immediately after treatment ends and many months later,” Lackner said.
Dr. Saurabh Sethi, a clinical instructor in gastroenterology at Stanford University who wasn’t associated with this study, is optimistic.
“IBS causes a huge public health and economic burden in the U.S. The standard of care currently has been diet changes along with medications. Although some of medications are over the counter, the others are relatively new, with not much long-term data in terms of their safety,” Sethi said.
“A mind-based intervention with such promising results is a very welcome finding in the GI world. It has the potential to minimize both the public health and economic burden of this debilitating disease,” he said.