Face-to-Face Cognitive-Behavioral Therapy for Irritable Bowel Syndrome: The Effects on Gastrointestinal and Psychiatric Symptoms.

Hanna Edebol-Carlman,Brjánn Ljótsson,Dirk Repsilber,Steven J Linton,Martien Schrooten,Katja Boersma,Robert J Brummer

doi:10.1155/2017/8915872

Hanna Edebol-Carlman, Brjánn Ljótsson + Show 5 more

Open Access

https://doi.org/10.1155/2017/8915872

Copy DOI

Abstract

Irritable bowel syndrome (IBS) is a gastrointestinal disorder linked to disturbances in the gut-brain axis. Visceral hypersensitivity and pain are hallmarks of IBS and linked to the physiological and psychological burden and to the nonadaptive coping with stress. Cognitive-behavioral therapy (CBT) for IBS has proven effective in reducing gastrointestinal and psychiatric symptoms in IBS by means of coping with stress. The present pilot study evaluated for the first time whether CBT for IBS affected visceral sensitivity and pain. Individual CBT was performed for 12 weeks in 18 subjects with IBS and evaluated in terms of visceral sensitivity and pain during rectal distensions using the barostat method and self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms. Visceral discomfort, urge, and pain induced by the barostat were not affected by CBT but were stable across the study. However, the level of self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms decreased after the intervention. Central working mechanisms and increased ability to cope with IBS-symptoms are suggested to play a key role in the alleviation of IBS symptoms produced by CBT.

Highlights

Irritable bowel syndrome (IBS) is a common multifactorial functional gastrointestinal disorder with a point prevalence of 11% in the adult western population [1]
The present study suggests that the effect of Cognitive-behavioral therapy (CBT) upon IBS symptoms is initiated by improved psychological coping of IBS rather than an altered visceral-afferent physiological functioning, tolerance, and/or ability to perceive rectal pain, discomfort, urge, and pressure
We found a significant effect of CBT on IBS symptomatology in another report with these same participants, our sample size may be too small for physiological measures, for example, barostat assessment of visceral pain

Summary

Introduction

Irritable bowel syndrome (IBS) is a common multifactorial functional gastrointestinal disorder with a point prevalence of 11% in the adult western population [1]. Clinical symptoms include visceral hypersensitivity, abdominal pain, discomfort, altered gastrointestinal motility, and secretion as described in the Rome criteria [2]. Visceral hypersensitivity is a key hallmark of IBS that involves pain originating from the intestinal organs and is poorly understood in terms of its etiology and management or treatment. It is enhanced by stress, anticipation, and inflammatory factors as implicated in preclinical and clinical studies in the context of for example, gender, gut microbiota, immune functioning in IBS [4], and neonates maternally separated [5]. Cognitions involving catastrophizing, rumination, and maladaptive coping are examples of cognitive-affective factors that play a role in the exacerbation of stress and IBS symptoms [8]

Methods

Results

Discussion

Conclusion