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Fighting IBS with Behavioral Therapy

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Up to 20 percent of Americans have symptoms of irritable bowel syndrome or IBS. In some cases, the symptoms are minor, but in others, they border on debilitating. Symptoms of IBS include abdominal pain, bloating and gas, cramping, constipation, and diarrhea. A diagnosis of IBS is made when symptoms occur at least three days out of the week and last at least three months.

Unfortunately, there is no cure for IBS. Treatment aims to relieve symptoms, and this typically requires a range of lifestyle changes.

Common home remedies and lifestyle changes include:
•Getting regular exercise to help keep things moving and improve overall health.
•Reducing caffeine, which can excite the digestive system.
•Eating smaller meals to reduce the impact of food on the gut.
•Minimizing stress, which can worsen symptoms.
•Taking daily probiotics: Stonehenge Health’s Dynamic Biotics.
•Avoiding spicy and deep-fried foods, which can cause pain, bloating and other issues.

If lifestyle changes don’t work to control your IBS symptoms, a few medications may be used to control muscle spasms, combat constipation, and reduce pain. But before you throw in the towel and opt for medication, consider giving cognitive-behavioral therapy a shot.

Treating IBS with Cognitive-Behavioral Therapy

Increasingly, the medical community is recommending cognitive-behavioral therapy, or CBT, as part of a holistic approach to treating IBS. Cognitive-behavioral therapy is a type of psychotherapy, or “talk therapy.” According to an article published in the journal Psychology Research and Behavior Management, CBT has been tested in numerous randomized, controlled trials and has been found to consistently produce significant effects on symptoms of IBS and overall quality of life.

The biopsychosocial framework of IBS addresses the interactions between biology, behavior, cognitive processes, and the environment. CBT addresses these interactions.

To break it down:
•Biology refers to things like genetic predisposition, low-grade inflammation, and altered gut microbiota.
•Behavior includes things like illness-related behaviors and symptom avoidance behaviors.
•Cognitive processes include coping skills, brain-gut dysregulation, and visceral anxiety.
•Environment refers to things like stressful life events, trauma, and lifestyle choices.

The biopsychosocial model centers on the brain-gut axis, which refers to the bi-directional and highly complex interactions between the brain and the gut. Stress and other psychological factors directly influence the functioning of the gut and contribute to IBS symptoms.

Recent research using brain imaging techniques have found abnormalities in central sensory processing among people with IBS. These include greater activation of emotional arousal networks among people with IBS, compared to those without, and a reduced ability to down-regulate pain.

Research also shows that people with IBS have increased anxiety and may develop a fear of social situations, worry about eating in public and misinterpret normal digestive processes as dangerous. They also may develop unhealthy coping mechanisms that increase stress and worsen symptoms. Cognitive-behavioral therapy targets cognitive processes that influence the brain-gut axis and improves symptoms.

Cognitive-behavioral therapy helps individuals with IBS examine their thoughts, beliefs, behaviors, and attitudes concerning their illness and change those that are dysfunctional or which make symptoms worse. By modifying thought and behavior patterns, people with IBS can enjoy improved symptoms and better coping skills, and research shows that these improvements are maintained for at least a year after treatment.

CBT for IBS is becoming more prevalent, but it’s still not easily accessible for some. Talk to your doctor about a referral to a licensed cognitive-behavioral therapist who works with IBS patients. If one isn’t available in your community, you can find one who conducts sessions online. If you have IBS and haven’t found relief from your symptoms through lifestyle changes, consider CBT. It can help you feel better and improve your quality of life by leaps and bounds.


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