Irritable bowel syndrome or IBS is without doubt the commonest condition that clients present to me as a nutritional therapist. This is not surprising given that in the UK it is estimated one adult in five are believed to suffer from IBS. Interestingly the rate is much higher amongst women (23%) than men (11%) for reasons that are not entirely clear. IBS is in reality an umbrella term for a range of gut related symptoms. It is often the case that IBS becomes the default diagnosis when all other disorders of the gut such as inflammatory bowel, celiac disease and bowel cancer have been ruled out.
There is unfortunately currently no specific diagnostic test for the condition. However the most common symptoms of IBS are stomach cramps which are relieved after a bowel movement, bloating, diarrhoea and/or constipation. Patients with one or more of these conditions for at least 3 days a month in the last 3 months are considered to meet the criteria for IBS (the Rome III diagnostic criteria).
There is no cure for IBS however the symptoms can usually be managed by medication and changes to diet and lifestyle. I will cover nutritional approaches to managing IBS in a future post, however in this post I want to focus on psychological interventions. Anxiety and depression are common in IBS sufferers and I have noted in many of my clients that stress can be a key trigger of a flare up in symptoms. This is perhaps unsurprising given the close relationship between our emotional state and the functioning of our gut (the gut brain connection).
Given this I was very interested to read the results of a recently published study that looked at the use of cognative behavioural therapy (CBT) to treat IBS suffers. CBT is a form of talking therapy that aims to change the way you respond to negative thought patterns, and in doing so improve your mental health. In the study, which lasted for 12 months, CBT sessions were delivered by either telephone or internet alongside the standard treatment of medication and GP support in one group. The second group continued standard treatment with medication and GP support. The researchers found that the group receiving CBT reported significantly better improvements in symptoms compared to patients just on medication and GP support alone. The full paper is available to read for free here and the NHS review of the study here
CBT is now accepted by the NHS as a useful treatment for IBS. However it can be difficult to access for many people, particularly those on low incomes. This study suggests that telephone or internet delivered CBT appears to work as well as face to face delivery which is encouraging as this could increase ease of access to IBS sufferers. It also reinforces the importance of treating IBS in a holistic way, by which I mean looking at the mind and body together rather than focusing on individual organs in isolation.