Why create a mind-body center for IBS patients?
Our experience — and the experience of many other IBS experts — is that medical treatment directed only at the colon often leaves the patient with continuing symptoms. Because IBS is often a result of both physical and psychological issues — with emotions affecting the colon and colonic symptoms affecting emotions — a holistic approach (treating the whole patient) is often necessary for long-term relief.
How important is diet?
In research studies of diet and IBS, certain foods have been shown to aggravate symptoms. An obvious example is dairy in individuals who have lactose intolerance (which can be tested for at the MBDC). And while onion and garlic are often poorly tolerated, patients may have to be their own investigators about foods that bother them.
On the other hand, it should be understood that diets should not be overly restricted since certain foods may cause symptoms one day and not another. This inconsistency shows that the state of the gastro-intestinal tract may be more important than a particular food. Some practitioners, without rigorous nutritional training, make routine recommendations to all IBS patients — no dairy, no gluten, no sugar, no yeast — without any scientific basis. Unfortunately, this may lead to malnutrition or unnecessarily restricted diet and this kind of advice should be avoided.
What is the role of the psychologist at the MBDC?
Psychological consultation is one of the two cornerstones of our Center. We believe that IBS is often worsened by psychological distress and that IBS also causes difficulties in living, which can be better managed with professional help. People frequently arrive at our Center discouraged about improvement although they often have resources within themselves that can be accessed to their advantage. We investigate past experiences that have led to heightened sensitivity to pressure or discouragement, we look at current relationships in terms of support and understanding, and we create personal strategies for coping.
How does hypnotherapy work?
Every day, the brain and the gut interact in many ways that influence digestive function. In IBS, there appears to be a dysregulation of the brain gut axis, which affects the way the brain responds to signals from the intestinal tract, and the way the intestine responds to signals from the brain. Using hypnotherapy, the patient becomes uniquely focused on soothing messages that are delivered by the therapist that create a vision of a healthy colon. Data has convincingly shown that IBS symptoms are significantly reduced by this method.
What kind of diagnostic tests are necessary in IBS?
The answer depends on the patient’s symptoms. In general, we feel that IBS patients have too many tests performed on them. If someone has IBS symptoms for a long time, has good general health and does not have what are described as red flags — significant rectal bleeding, significant weight loss, onset after the age of 50, abnormal blood tests such as anemia — then it is extremely unlikely that diagnostic tests will help. Too many endoscopic procedures are being performed on the patients that we see. Of course, it’s difficult to generalize and there are situations that require performance of certain procedures.
What is the treatment philosophy at the MBDC?
Our approach is to help the patient in any way that we can, which means that we use prescription medication, over-the-counter supplements, psychological therapies and acupuncture, all depending on the patient’s situation. One of our tenets is to base treatment recommendations on solid research data that has documented effectiveness of treatment. We believe that many patients are also helped by a hopeful and positive attitude, a strong focus on the patient’s story and the creation of what we think of as a therapeutic environment at our Center.