Psychotherapy Has Long Term Benefits for Irritable Bowel Syndrome Sufferers

For some time doctors have known that psychological therapies can reduce the symptoms of irritable bowel syndrome in the short term.

IBS is a gastrointestinal disorder that affects 7 – 16 percent of the U.S. population, adding somewhere between $950 million to $1.35 billion annually to the nation’s healthcare bill.

A new meta-analysis, published online on Dec. 22, 2015 by the journal Clinical Gastroenterology and Hepatology, has now found that the beneficial effects of psychological therapy also appear to last at least six to 12 months after the therapy has concluded. The study analyzed the results of 41 clinical trials from a number of different countries containing more than 2,200 patients.

“Our study is the first one that has looked at long-term effects,” said senior author Lynn S. Walker, professor of pediatrics at Vanderbilt University Medical Center. “We found that the moderate benefit that psychological therapies confer in the short term continue over the long term. This is significant because IBS is a chronic, intermittent condition for which there is no good medical treatment.”

IBS, which is characterized by chronic abdominal pain, discomfort, bloating, diarrhea or constipation, is classified as a disorder of the “brain-gut axis.” Although no cure is known, there are treatments to relieve symptoms including dietary adjustments, medication and psychological interventions.

“Western medicine often conceptualizes the mind as separate from the body, but IBS is a perfect example of how the two are connected,” said first author Kelsey Laird, a doctoral student in Vanderbilt’s clinical psychology program. “Gastrointestinal symptoms can increase stress and anxiety, which can increase the severity of the symptoms. This is a vicious cycle that psychological treatment can help break.”

The studies that Laird analyzed included a number of different types of psychological therapies, including cognitive therapies, relaxation and hypnosis. Her analysis found no significant difference in the effectiveness of different types of psychotherapy. It also found that the length of the treatment (the number of sessions) didn’t matter.

Image shows a woman bent over, grasping her belly.
IBS, which is characterized by chronic abdominal pain, discomfort, bloating, diarrhea or constipation, is classified as a disorder of the “brain-gut axis.” Although no cure is known, there are treatments to relieve symptoms including dietary adjustments, medication and psychological interventions. Image is adapted from the Vanderbilt University press release.

Possibly most significant from a healthcare cost perspective was the finding that treatments conducted online appear to be equally as effective as those conducted in person.

“In this study we looked at the effect of psychological therapies on gastrointestinal symptoms. In a follow-up study I am investigating the effect that they have on patients’ ability to function: go to work, go to school, participate in social activities and so on,” Laird said.

[divider]About this psychology research[/divider]

Paper co-authors are Research Assistant Professor Emily Tanner-Smith at the Peabody Research Institute, clinical fellow Alexandra Russell in Pediatrics and Gertrude Conaway Professor of Psychology Steven Hollon.

Source: David F Salisbury – Vanderbilt University
Image Source: The image is adapted from the Vanderbilt University press release
Original Research: Full open access research for “Short- and Long- Term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis” by Kelsey T. Laird, Emily E. Tanner-Smith, Alexandra C. Russell, Steve D. Hollon, and Lynn S. Walker in Clinical Gastroenterology and Hepatology. Published online December 22 2015 doi:10.1016/j.cgh.2015.11.020


Abstract

Short- and Long- Term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Background & Aims
Several meta-analyses have demonstrated the efficacy of psychological therapies for reducing gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). However, no meta-analysis has investigated the duration of these effects. We performed a meta-analysis to assess the immediate, short-term, and long-term efficacy of psychotherapy for reducing GI symptoms in adults with IBS.

Methods
We searched PubMed, PsycINFO, Science Direct, and ProQuest Dissertations and Theses through August 15th 2015 for randomized controlled trials that compared psychological therapy to an active or non-active comparison condition (controls) for treatment of GI symptoms in adults with IBS.

Results
Forty-one trials were included in our meta-analysis, comprising data from 2290 individuals (1183 assigned to psychotherapy and 1107 assigned to a control condition). Compared to a mixed group of control conditions, psychological therapies had a medium effect on GI symptom severity (Math Eq= =0.69) immediately after treatment. On average, individuals who received psychotherapy had a greater reduction in GI symptoms following treatment than 75% of individuals assigned to a control condition. After short-term follow-up periods (1–6 months after treatment) and long-term follow-up periods (6–12 months after treatment), this effect remained significant and medium in magnitude (Math Eq=0.76 and Math Eq=0.73, respectively).

Conclusions
Psychological therapies reduce GI symptoms in adults with IBS. These effects remained significant and medium in magnitude after short- and long-term follow-up periods.

“Short- and Long- Term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis” by Kelsey T. Laird, Emily E. Tanner-Smith, Alexandra C. Russell, Steve D. Hollon, and Lynn S. Walker in Clinical Gastroenterology and Hepatology. Published online December 22 2015 doi:10.1016/j.cgh.2015.11.020

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