IBS Treatment: Psychotherapy

IBS Treatment: Psychotherapy

For people with IBS patients and a psychiatric illness, psychotherapy has been used for treatment and has proven successful.  Although initially more expensive than standard medical care, psychotherapy has demonstrated over the long term to be more cost effective or cheaper.  Several studies have suggested that the benefits achieved with psychotherapy may be long-lasting.  Those with a long history of psychiatric illness and people with constant pain did not fare as well.  The people who benefited the most were those who acknowledged the link between the worsening of their symptoms and stress and those who presented with anxiety and depression.

With the pace of life these days, it is much easier to prescribe medication to deal with or resolve each symptom.  However, with IBS, a wholesome approach is often necessary.  It is a catch 22 sometimes.  It is, at times, very difficult to discern which preceded which, or whether one is a complication of the first.  If overt symptoms of psychiatric illness are seen, the order of the problems become less consequential, because both will have to be treated and a specific regimen directed toward the psychological disorder.  Treatment will be geared toward the entire person or experience and may involve relationships, thoughts, and feelings.

There are several types of psychological therapies, these include: 1) behavioral therapy, 2) cognitive therapy, 3) psychoanalytic and psychodynamic psychotherapy, 4) insight-oriented psychotherapy and 5) group therapy.  The goal of behavioral therapy is to influence what the person does.  Cognitive therapy is aimed at having the person recognize expectations and creating a positive picture.  Psychoanalytic and Psychodynamic psychotherapy involve the person telling the therapist about their problems, and by doing this, the person may be able to see the origins of their problems and then change them as the therapist makes interpretations.  It also has the patient examine and reflect on personal issues.  Insight-oriented psychotherapy is more intellectual in that it encourages the person to try to understand the crux of their problem with the help and support from the therapist.  Group therapy provides a social environment of people with similar experiences for interaction and support.

Cognitive-behavioral therapy is one of the most commonly used psychotherapies for people with IBS.  Studies have found them effective in treating the symptoms of IBS.  The limiting factors for treating IBS with psychotherapy are the cost, time commitment, and availability.  The start-up costs are usually the stumbling block and a deterrent to initiating treatment.  Over the long term, however, it is much cheaper because it reduces hospitalization.  Psychotherapy can also be time-consuming.  It often requires one-on-one consultations that require many hours before positive results are achieved.  Also, these consultations are not readily available.  More and more people with IBS are relying on psychotherapy to help relieve their symptoms.  Also with more specialists and doctors being trained in psychotherapy, the future is bright for its use in the treatment of IBS.

Andreasen NC, Black DW. Introductory Textbook of Psychiatry. Second ed. Washington, DC: American Psychiatric Press, Inc.; 1995.

Spiller RC. Potential future therapies for irritable bowel syndrome: will disease modifying therapy as opposed to symptomatic control become a reality? Gastroenterol Clin North Am. Jun 2005;34(2):337-354.