Home-based cognitive behavioral therapy relieves IBS symptoms

Jun 25, 2008

Persons with irritable bowel syndrome (IBS) can relieve their symptoms as effectively by following a self-administered, at-home cognitive behavioral program as they can by undergoing a 10-week in-office program administered by a trained therapist, a new pilot study has shown. The findings are important because there are no reliable medicines available to treat successfully the full range of symptoms of this chronic, often debilitating, disorder that affects an estimated 14-24 percent of women and 5-19 percent of men in the U.S.

The study is posted online on the Clinical Gastroenterology and Hepatology's Web site and will be published in the journal's July 2008 issue.

Jeffrey M. Lackner, Psy.D., assistant professor in the Division of Gastroenterology in the University at Buffalo School of Medicine and Biomedical Sciences and director of its Behavioral Medicine Clinic at the Erie County Medical Center, is first author.

"The value of this study is that it shows that patients can learn relatively simple self-care skills to take control of symptoms that are resistant to existing medical treatments," said Lackner. "This is a dramatic example of the complexity of brain-gut interactions."

IBS is characterized by chronic abdominal pain and discomfort, diarrhea and/or constipation. Cognitive behavioral therapy (CBT) has been shown to improve symptoms, quality of life and psychological stress, but there is a shortage of trained CBT therapists, which has created long waiting lists.

The treatment also is expensive and time consuming, requiring 10-12 in-office sessions, a schedule many patients are unable or unwilling to maintain. In addition, IBS specialty clinics are rare, so patients are deprived of the state-of-the-art treatment available at UB.

To help solve these problems, Lackner and colleagues designed a primarily self-administered treatment program that patients can learn at home, using self-study materials, supplemented by four in-office counseling sessions.

"Patients can follow a program like this at their own pace and on their own time," Lackner noted, "and perhaps most important, they can learn these skills in the environment where symptoms are most likely to occur. It also requires less travel, which makes it convenient for patients with busy lifestyles and for those in underserved and rural areas."

The researchers tested the program's effectiveness in a pilot study involving 75 IBS-diagnosed patients who were randomized to one of three groups: a standard 10-session therapist-administered cognitive therapy group (CBT); a "minimal-contact" CBT group (MC-CBT) that included the home-based program and a wait-list group (WL). This last group simply monitored their gastrointestinal symptoms daily.

All participants were interviewed two weeks after the end of the 10-week treatment period to gather information on overall relief of symptoms and improved quality of life.

Patients in both therapy groups reported clinically significant relief of symptoms: 60.9 percent in the CBT group and 72 percent for MC-CBT. Only 7.4 percent of the wait-list group reported improvement. Patients in both treatment groups also reported significant improvement in quality of life.

"The finding that a self-administered approach can be successful in reducing IBS symptoms is important at this point in time, when few validated therapies are available for patients," said Lackner.

"Further research is needed to establish the therapeutic potential of this novel approach to managing IBS, as well as to understand how these treatments work and the conditions under which they are most likely to achieve the desired effects."

Source: University at Buffalo

Explore further: New evidence helps health workers in the fight against Ebola

add to favorites email to friend print save as pdf

Related Stories

Study characterizes genetic resistance to wheat disease

36 minutes ago

A new study co-authored by University of Nebraska-Lincoln researchers has unearthed the genetic roots of resistance to a wheat disease that has recently devastated crop yields from southern Africa through ...

Linguists tackle computational analysis of grammar

36 minutes ago

Children don't have to be told that "cat" and "cats" are variants of the same word—they pick it up just by listening. To a computer, though, they're as different as, well, cats and dogs. Yet it's computers ...

Ultra-small block 'M' illustrates big ideas in drug delivery

49 minutes ago

By making what might be the world's smallest three-dimensional unofficial Block "M," University of Michigan researchers have demonstrated a nanoparticle manufacturing process capable of producing multilayered, precise shapes.

Recommended for you

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.