Behavioral Therapy for IBS

One approach to coping with irritable bowel syndrome (IBS) is behavioral therapy. Why? Stress and anxiety can worsen IBS symptoms. Behavioral therapy can help you cope with these feelings, thus reduce some IBS symptoms. It's not known what causes pressure and worry to trigger stomach pain, discomfort, diarrhea, or constipation. But learning how to effectively manage emotional reactions seems to prevent or ease suffering.

"The majority of IBS patients seem to show some improvement with behavioral therapy," says Philip Schoenfeld, MD, MSEd, MSc. He is the co-author of the IBS treatment guidelines published by the American College of Gastroenterology.

There's an added benefit, he notes. People also tend to have fewer symptoms of anxiety and depression when their IBS symptoms improve.

Behavioral therapy helps people learn how to better cope with pain and discomfort, and how to relieve stressful situations in order to ward off severe IBS symptoms.

Unfortunately, behavioral therapy is not a cure-all. Some studies have shown the strategy does nothing for symptoms of constipation and constant stomachaches. Other studies show it's best used with standard medical care. Before starting any form of therapy, talk with your doctor about how it may fit into your overall treatment plan.

There are many different types of behavioral therapy. Here are techniques that have worked in some people with IBS:

• Relaxation therapy. The goal is to get the mind and body in a calm, peaceful state. Techniques include meditation, progressive muscle relaxation (tensing and loosening individual muscles), guided imagery (visualization), and deep breathing.
• Biofeedback. This strategy uses an electrical device to help people recognize their body's response to stress. Participants are taught, with the machine's help, to slow down their heart rate to a more relaxed state. After a few sessions, people are able to calm themselves down on their own.
• Hypnotherapy. Participants enter an altered state of consciousness, either with a trained professional's help or on their own (after training). In this altered condition, visual suggestions are made to imagine pain going away.
• Cognitive Behavioral Therapy. This is a form of psychotherapy that teaches you to analyze negative, distorted thoughts, and replace them with more positive and realistic thoughts.
• Traditional Psychotherapy. A trained mental health professional helps patients work out conflicts and understand feelings.

Jeffrey Roberts, president and founder of the IBS Self-Help and Support Group, uses a type of relaxation therapy to help him manage oncoming stress and pain related to IBS. He imagines a box in his head, breathes through one side, pauses, and breathes through the other side. He repeats this process until he feels calm.

For the most part, the breathing exercises help Roberts live his life as comfortably as possible with IBS. There are times, though, when his pain and discomfort is so severe that he is unable to go to work or attend events.

"I can't say that somebody can lead a normal life with IBS, but you could live as normal life as you could possibly live," he says.

There are also medicines to help with IBS symptoms. Other treatment options include changes in diet, stress management, and alternative therapies such as acupuncture or hypnosis.

Talk with your doctor about the best way to manage your IBS.