Irritable Bowel Syndrome and the Brain Revisited

A few weeks ago, I wrote about irritable bowel syndrome (IBS) and the abnormal brain activity seen on magnetic resonance imaging (MRI) in a recent clinical trial. These findings supported the theory that patients with IBS have an altered sensation of abdominal pain and respond more strongly and more emotionally to pain than unaffected patients.

Now, researcher at the the University of Buffalo, State University of New York have shown that the powers of the mind can be harnessed to effectively reduce the symptoms of pain, bloating and altered bowel function.

Cognitive behavioral therapy proved effective for IBS patients in a recent trial, whether it was administered by a certified therapist or by at-home techniques. Cognitive behavioral therapy (CBT) focuses on replacing negative beliefs and behaviors with positive ones. Self-administered techniques were included because many patients do not have access to CBT-trained therapists who treat IBS. These at-home techniques included relaxation and problem-solving exercises.

Other studies have found hypnotherapy to be beneficial in the majority of IBS patients.

These findings further support the interconnected nature of the gut and the mind, and the alterations in this relationship that result in IBS. It is well known that IBS symptoms are worsened by stress or negative emotions and improved with relaxation. CBT and hypnotherapy both exploit the power of the mind to control peripheral sensations — like abdominal pain and bloating — and allow patients to better control their reactions to these events.

Current medications available to IBS patients include painkillers, laxatives and anti-diarrhea agents. Unfortunately, these medicines only treat the symptoms and do not address the underlying cause. And for many patients, medications provide little or no relief at all. This is probably because the real problem does not lie in the digestive tract, but in the brain, where processing of sensations from the gut takes place.

By directly targeting the brain, CBT and hypnotherapy may prove more effective for many patients who do not respond to traditional medical therapy. These psychological therapies may allow the brain to ignore or correct the abnormal processing of gut sensation that leads to pain and discomfort.

References

Berman, S.M., Naliboff, B.D., Suyenobu, B., Labus, J.S., Stains, J., Ohning, G., Kilpatrick, L., Bueller, J.A., Ruby, K., Jarcho, J., Mayer, E.A. (2008). Reduced Brainstem Inhibition during Anticipated Pelvic Visceral Pain Correlates with Enhanced Brain Response to the Visceral Stimulus in Women with Irritable Bowel Syndrome. Journal of Neuroscience, 28(2), 349-359. DOI: 10.1523/JNEUROSCI.2500-07.2008

Naliboff, B.D., Frese, M.P., Rapgay, L. (2007). Mind/Body Psychological Treatments for Irritable Bowel Syndrome. Evidence-based Complementary and Alternative Medicine, 5(1), 41-50. DOI: 10.1093/ecam/nem046