What Strategies Do Patients With Irritable Bowel Syndrome Continue to Use Following a 9-Week Comprehensive Self-Management Program?

Abstract

Introduction: The aims of this study were to identify strategies patients with irritable bowel syndrome (IBS) continued to use following a 9-week comprehensive self-management (CSM) program. Methods: This secondary analysis includes data collected at the last CSM session and 6 and 12 months post-randomization from adult with IBS randomized to receive CSM intervention. During the last CSM session, subjects identified CSM strategies they intended to continue using in each of the following categories: diet, relaxation, and alternative thinking. For each identified strategy, subjects were asked at the 6- and 12-month follow-up times to rate how often they used it on a 5-point scale (1 = not at all to 5 = almost always). Individual strategies were categorized into 9 themes: 1) meal timing/frequency, 2) trigger food reduction/elimination, 3) eating behaviors (e.g., avoid eating out, eat more slowly, etc.), 4) balanced diet (e.g., fiber, fluids, etc.), 5) specific relaxation strategies (e.g., abdominal breathing, body scan, etc.), 6) lifestyle behaviors (e.g., exercise, hobbies, etc.), 7) thought distortions (e.g., all or nothing thinking, overgeneralization of negative, etc.), 8) challenging beliefs (e.g., perfectionism, self-esteem, etc.) and 9) problem-solving skills (e.g., find support, refocus, etc.).Table 1Results: The majority of subjects were female (N=88, 87%) and the mean age was 44 years (SD=14). The first column of the table shows, for each theme, the percentage of subjects who reported at their last CSM session their intention to continue using strategies from that theme. The second column shows the percentage of subjects who reported at 12 months post-randomization that they have continued to use strategies from that theme at least 2 days a week. Conclusion: Our 9-week CSM program resulted in sustainable behavioral changes for IBS symptom management in the majority of our subjects. An advantage of the multi-component CSM intervention is that patients can determine which strategies are most effective at alleviating their IBS symptoms and continue to use them.