Bowel and Bladder-Control Anxiety: A Preliminary Description of a Viscerally-Centred Phobic Syndrome

Abstract

This preliminary characterization indicates that even in a non-treatment seeking community sample, bowel/bladder-control anxieties are associated with high levels of distress and impairment. Further careful characterization of these anxieties will clarify their phenomenology and help us develop or modify treatment protocols in a way that takes account of any special characteristics of such viscerally-centred phobic syndromes.

Do Symptoms of Irritable Bowel Syndrome Improve when Patients Receive Cognitive Behavioural Therapy for Co-morbid Anxiety Disorders in a Primary Care Psychological Therapy (IAPT) Service?

“…These observations lend support to the proposal of BCA as a discrete, viscerally centred phobic syndrome (Kamboj et al, 2015). Patients with BCA, whose beliefs and maintaining behaviours were identified and addressed in treatment, had greater reductions in IBS symptoms, as well as greater reductions in both social and agoraphobic avoidance at 6-month follow-up, compared with patients without BCA.…”

“…These preliminary findings in a routine IAPT service build upon the findings of an internet study of non-treatment-seeking IBS sufferers (Kamboj et al, 2015) that proposed the conceptualization of bowel control anxiety as a discrete, viscerally centred phobic syndrome. This study found a similar phenomenology of BCA phobic cognitions and behaviours in a clinical population of IBS sufferers who sought treatment for anxiety disorders in a primary care IAPT service.…”

“…However, the fact that these beliefs/fears about IBS symptoms were formally recorded in assessment reports may have increased the likelihood of therapists addressing them directly in treatment. Since completion of this study, a ‘Fear of incontinence survey’ has been developed and published (Kamboj et al, 2015), which could be used in future investigations.…”

“…A commonly reported anxiety problem related to IBS that might require specific therapeutic competencies/interventions in order to improve, is bowel control anxiety (BCA), in which sufferers fear losing control of their bowels, and being incontinent in public (Kamboj et al, 2015). This problem has been associated with panic due to the intense focus on physical symptoms (e.g.…”

Cognitive Behavioral Therapy Treatment for a Woman with Bowel and Bladder Obsession

“…In some patients, an exaggeration in visceral sensations can be accompanied with obsession and catastrophic fears that the patient may imminently loss control of their bladder or bowel functioning, a condition known as bowel-and-bladder control anxiety (Pajak & Kamboj, 2014;Biedel & Bulik, 1990;Cosci, 2013;Kamboj, Langoff, Pajak, Zhu, Chevalier, & Watson, 2013). Patients with the disease tend to obsessively check for internal sensation and tend to have compulsive voiding behavior, as well as, an overwhelming fear that they can lose control of their bladder and bowel functioning (Pajak & Kamboj, 2014).…”