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Mind-body education helps irritable bowel syndrome

By Kerry Grens

NEW YORK (Reuters Health) - Patients who go through a mind-body educational course are better able to manage irritable bowel syndrome (IBS), according to a new study.

The benefits of the course were modest, about as large as what are typically seen from taking medications, said Dr. Emeran Mayer, the senior author of the study and a professor at the University of California, Los Angeles, School of Medicine.

The program doesn't work for everybody, said Mayer, but for others "it changed their lives."

The researchers couldn't describe exactly how patients' lives were changed, but those in the study reported having somewhat less severe symptoms and a higher quality of life after they went through the program.

Irritable bowel syndrome is a collection of symptoms, including stomach pain and diarrhea, that don't have a known inflammatory component like inflammatory bowel disease.

According to Mayer's study, published in Alimentary Pharmacology and Therapeutics, up to 15 percent of people experience IBS.

Although fiber supplements, antidiarrheal drugs and antidepressants can be used to ease some of the symptoms of IBS, there is no cure.

Some studies have found success with talk therapy, meditation and hypnosis (see Reuters Health reports of November 1, 2011 http://reut.rs/uOYJ8l, June 29, 2011 http://reut.rs/kbJOwu, and May 4, 2010 http://reut.rs/h2R0Ac).

In the current study, Mayer and his colleagues developed a group education program, in which patients attended two-hour sessions once a week for five weeks. The discussions centered on the role of the brain in regulating digestion, how responses to stressful events can affect IBS, and strategies to better manage symptoms.

The researchers compared the symptoms, quality of life, and mental health between 34 people who went through the course to 35 patients who were told they were on a wait list.

By the end of the sessions, patients reported that the severity of their symptoms dropped from about 10 down to about 8 on a 20-point scale. And three months after the program ended, these patients reported that the severity of their symptoms was at about 7.

In comparison, the wait-listed group reported that their symptoms went from about 13 to about 11 at the end of five weeks, and down to about 10 three months later.

The researchers could not describe just what these changes mean in day-to-day terms.

Similarly, the quality of life for patients in the education group rose from about 67 to nearly 76 on a 100-point scale by the end of the sessions, whereas the quality of life reported by the wait-listed group had a small drop from about 64 to about 62.

Patients in the mind-body course also showed some signs of better coping skills. For instance, people were less likely make the worst out of a given situation if they had gone through the sessions.

ENOUGH THERAPISTS?

The findings are "part of larger set of data that says that the brain seems to be really important in the brain-gut interactions as they relate to IBS symptoms," said Jeffrey Lackner, a professor at the State University of New York at Buffalo who was not involved in the study.

Lackner said it's not entirely clear yet how meaningful the improvements on these measures will be to people's everyday lives. He said that future research should explore just how much, in a practical way, patients' lives change.

The changes seen after the educational program are not huge, Mayer said, but they would be noticeable to the patients. "I would prefer to see much larger changes," he told Reuters Health.

Dr. Arnold Wald, a professor of medicine at the University of Wisconsin who was not involved in the study, said he's not surprised to see that the program made some difference to people's illness.

He explained that one of the premises of the mind-body approach to treating IBS "is that the mind and the body are linked, physically, neurologically, as well as emotionally, and that things that affect the mind can affect the gut and vice versa. So if you can do something to alleviate mind stressors, you can improve body functions."

"Instead of when symptoms happen to them, saying, 'I'm going to have the worst abdominal pain of my life and I'm not going to make it to this meeting,'...they can say, 'I know about stress, I can rationally implement specific steps" to reduce it, Mayer said.

But whether such treatments will reach large numbers of people is unclear. Lackner said there are few therapists in the U.S. who focus on IBS.

Mayer's group is developing online programs to help make his approach more accessible.

SOURCE: http://bit.ly/U8hjKn Alimentary Pharmacology and Therapeutics, online December 3, 2012.

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