Psychotherapy May Have Lasting Benefits for Irritable Bowel Syndrome

By Charles Gerson, M.D.

An article in the New York Times by Nicholas Bakalar highlighted the findings of a recent medical article about psychotherapy in IBS. The publication was published in a major GI journal, Clinical Gastroenterology and Hepatology. What is important about this article? Various forms of psychotherapy including psychodynamic therapy, cognitive-behavioral therapy and hypnotherapy were all beneficial in reducing IBS symptoms.

The authors reviewed a large number of IBS psychotherapy publications that recorded short- term and long-term (up to one year) symptom improvement after therapy. Only publications with a control population who did not receive therapy were included in the review.

There are a number of reasons for publicizing this study and the conclusion supports the treatment approach that we use at the Mind-Body Digestive Center. Traditionally, physicians try to establish a diagnosis based on findings such as an abnormal laboratory test or inflammation of the colon which can be seen through a colonoscope. Treatment is based on writing a prescription aimed at the cause of a disease or the symptoms experienced by the patient.

But IBS is different. There are no abnormal laboratory tests and colonoscopies are normal. Symptoms often change so it may be difficult to find a remedy: patients may alternate between diarrhea and constipation so treatment directed towards one extreme may propel the patient to the other extreme. Treatment is also complicated by the fact that there are many links between the emotions and gastro-intestinal symptoms.

Thus, this review of the medical literature is very reassuring and provides additional validation that a mind-body approach which may include psychotherapy and hypnotherapy, both modalities available at the MBDC, is an important component of IBS treatment. Of course, finding a physician who has empathy for the patient and understands the complexities of IBS is essential.