Mind/Body Psychological Treatments for Irritable Bowel Syndrome

Naliboff, Bruce D.; Frese, Michael; Rapgay, Lobsang

doi:10.1093/ecam/nem046

Cited by 49 publications

(42 citation statements)

References 60 publications

(59 reference statements)

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“…Studies indicate that psychological treatments such as CBT, psychodynamic therapy, and hypnotherapy can be somewhat effective in ameliorating IBS symptoms [47]. However, improvement is moderate and inconsistent; IBS remains for most patients a chronic condition, and therefore mindfulness approaches, with their focus on acceptance and global change, has potential to be particularly efficacious [48]. This is indirectly supported by findings that pain catastrophizing accounts for 46% of the variance in suffering in IBS patients [49].…”

Section: Resultsmentioning

confidence: 97%

Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis

2013

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BackgroundMindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.MethodsThirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment.FindingsWhile limited in power, the meta-analysis indicated a small to moderate positive effect of MBT (compared to wait-list or support group controls) in reducing pain (SMD = −0.21, 95% CI: −0.37, −0.03; p<0.05), symptom severity (SMD = −0.40, 95% CI: −0.54, −0.26; p<0.001), depression (SMD = −0.23, 95% CI: −0.40, −0.07, p<0.01), and anxiety (SMD = −0.20, 95% CI: −0.42, 0.02, p = 0.07) associated with somatization disorders, and improving quality of life (SMD = 0.39, 95% CI: 0.19, 0.59; p<0.001) in patients with this disorder. Subgroup analyses indicated that the efficacy of MBT was most consistent for irritable bowel syndrome (p<0.001 for pain, symptom severity, and quality of life), and that mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MCBT) were more effective than eclectic/unspecified MBT.ConclusionsPreliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted.

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Section: Resultsmentioning

confidence: 97%

Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis

2013

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“…However, the outcomes of two recent large scale controlled trials of CBT for IBS were not as positive (Blanchard et al, 2007;Drossman et al, 2003). In light of the inconsistent effects of traditional CBT, Naliboff and colleagues suggested that CBT approaches targeted at other mechanisms than altering the content of thoughts, specifically mindfulness meditation and acceptance and commitment therapy (ACT), should be tried as treatments for IBS (Naliboff, Frese, & Rapgay, 2008). The goal of ACT and mindfulness meditation is to decrease ''experiential avoidance'', defined as the unwillingness to experience aversive bodily sensations, emotions, and thoughts (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996).…”

Section: Introductionmentioning

confidence: 99%

“…attempts to decrease or avoid it, are also likely to maintain the disorder. For example, avoiding social or work-related situations when experiencing symptoms can cause social isolation and depression, worsening the symptoms through increased anxiety (Naliboff et al, 2008). A common behavior like distraction from the associated pain is probably not very effective and might even increase the awareness of pain (Cioffi, 1991;McCracken, 1997).…”

Section: Introductionmentioning

confidence: 99%

Exposure and mindfulness based therapy for irritable bowel syndrome – An open pilot study

Ljótsson

Andréewitch

Hedman

et al. 2010

Journal of Behavior Therapy and Experimental Psychiatry

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“…Fear of pain and/or diarrhea may severely limit the adolescent and YA patient’s willingness to attend school and social outings. Such fear further exacerbates symptoms, and over time, IBS symptoms and fear of pain can evolve into a vicious cycle in a young person (6). …”

mentioning

confidence: 99%

Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome

Evans

Lung

Seidman

et al. 2014

J. pediatr. gastroenterol. nutr.

135

106

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Objectives Irritable bowel syndrome (IBS) is a chronic, disabling condition that greatly compromises patient functioning. The aim of this study was to assess the impact of a 6-week twice per week Iyengar yoga (IY) program on IBS symptoms in adolescents and young adults (YA) with IBS compared with a usual-care waitlist control group. Methods Assessments of symptoms, global improvement, pain, health-related quality of life, psychological distress, functional disability, fatigue, and sleep were collected pre- and posttreatment. Weekly ratings of pain, IBS symptoms, and global improvement were also recorded until 2-month follow-up. A total of 51 participants completed the intervention (yoga = 29; usual-care waitlist = 22). Results Baseline attrition was 24%. On average, the yoga group attended 75% of classes. Analyses were divided by age group. Relative to controls, adolescents (14–17 years) assigned to yoga reported significantly improved physical functioning, whereas YA (18–26 years) assigned to yoga reported significantly improved IBS symptoms, global improvement, disability, psychological distress, sleep quality, and fatigue. Although abdominal pain intensity was statistically unchanged, 44% of adolescents and 46% of YA reported a minimally clinically significant reduction in pain following yoga, and one-third of YA reported clinically significant levels of global symptom improvement. Analysis of the uncontrolled effects and maintenance of treatment effects for adolescents revealed global improvement immediately post-yoga that was not maintained at follow-up. For YA, global improvement, worst pain, constipation, and nausea were significantly improved postyoga, but only global improvement, worst pain, and nausea maintained at the 2-month follow-up. Conclusions The findings suggest that a brief IY intervention is a feasible and safe adjunctive treatment for young people with IBS, leading to benefits in a number of IBS-specific and general functioning domains for YA. The age-specific results suggest that yoga interventions may be most fruitful when developmentally tailored.

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Mind/Body Psychological Treatments for Irritable Bowel Syndrome

Cited by 49 publications

References 60 publications

Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis

Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis

Exposure and mindfulness based therapy for irritable bowel syndrome – An open pilot study

Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome

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