In a controlled and independent study, cognitive therapy demonstrates immediate and lasting effectiveness on the pain and digestive disorders of irritable bowel syndrome.
In irritable bowel syndrome, a disease that causes stomach pain and diarrhea or constipation, the largest independent clinical trial to date shows that people with the most intense and chronic symptoms get significant relief and sustainable by learning to control them through cognitive therapy.
It is also one of the largest trials evaluating behavioral medicine without a drug comparator. It was funded by various US government institutions. The study is published online in the journal Gastroentrology.
Interesting results
Among the 436 patients recruited according to the Rome criteria, and drawn at random between cognitive therapy and therapeutic education alone, 61% of those who had a CBT reported an improvement in symptoms two weeks after the end of behavioral treatment (55% of after gastroenterologists) versus 43% for those who had only therapeutic education sessions (40% if assessed by gastroenterologists).
The benefit of treatment persists for up to six months after the end of treatment. “This is an innovative and revolutionary approach to a real public health problem that has personal and economic costs and for which there are few medical treatments for all of the symptoms,” said Jeffrey Lackner, senior author study and researcher at the Jacobs Faculty of Medicine at the University of British Columbia.
Women are the most affected
Irritable Bowel Syndrome is a chronic and difficult to treat disease that is also one of the most common illnesses that gastroenterologists and general practitioners have to deal with.
This chronic disease is characterized by recurrent stomach pain, diarrhea and / or constipation. Medical and dietetic treatments have a disappointing and often incomplete result in many patients. Irritable bowel syndrome is thought to affect 10 to 15% of adults worldwide, most of whom are women. Beyond personal suffering, its economic cost to the United States is estimated at $ 28 billion each year.
Brain-gut connections
Treatment consists of a form of cognitive behavioral therapy (CBT) that teaches practical ways to control gastrointestinal symptoms, either during 10 visits to a therapist or four home sessions in conjunction with self-study materials. developed by Lackner in a previous study.
Both types of CBT have focused on information regarding brain-gut interactions, symptom self-monitoring, triggers and consequences, worry control, muscle relaxation, and flexible problem-solving.
Demonstrating the existence of a brain-gut connection
“This treatment is based on the latest research which shows that the brain-gut connection is a two-way street,” Lackner explained. “Our study shows that patients can learn to recalibrate these brain-gut interactions in such a way that they experience a significant improvement in their symptoms, which medical treatments cannot do. “The strength of the study lies in the fact that both the patients and the gastroenterologists who assessed them (and who did not know which patients were treated), reported similar improvement rates.
.@AmerGastroAssn Clinical Practice Update by @drlauriekeefer et al. discusses incorporating psychological care in the management of chronic digestive diseases. Read coverage in GI & Hep News: https://t.co/vEyXHYLBYt
– Gastroenterology (@AGA_Gastro) April 19, 2018
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