IBS and “Mindfulness”

A therapy that combines mindfulness meditation and gentle yoga may help soothe symptoms of irritable bowel syndrome, a small clinical trial suggests.

In a study of 75 women with the digestive disorder, researchers found that those assigned to “mindfulness training” saw a bigger improvement in their symptoms over three months than women who were assigned to a support group.

The findings, they say, suggest that the mindfulness technique should be an option for treating irritable bowel syndrome (IBS).

A doctor not involved in the study agreed.

“I think people with IBS should learn mindfulness skills,” said Dr. Delia Chiaramonte, director of education for the University of Maryland’s Center for Integrative Medicine in Baltimore.

Learning such skills, she said in an interview, is “100 percent safe,” and it could offer people a way to help manage IBS symptoms on their own, long term.

People with IBS have repeated bouts of abdominal cramps, bloating, constipation and diarrhea. The typical treatment includes diet changes, as well as anti-diarrhea medication and, for constipation, laxatives or fiber supplements. There’s also some evidence that regular, moderate exercise helps.

The exact cause of IBS is unknown, but anxiety and less-than-ideal coping strategies — like avoiding going out because of your symptoms — are thought to make IBS worse for many people.

Because of that, psychological counseling is sometimes used. The best-studied form is cognitive behavioral therapy, which tries to change the unhealthy thinking patterns and behaviors that contribute to people’s health problems.

For the new study, Susan A. Gaylord and colleagues at the University of North Carolina, Chapel Hill, looked at a different approach to managing the “brain-gut” connection — known as mindfulness-based stress reduction.

The researchers randomly assigned 75 women with IBS to either undergo the mindfulness training or attend an IBS support group once a week for eight weeks.

The training included lessons on meditation, gentle yoga postures and “body scanning,” in which people focus their attention on one body area at a time to detect muscle tension and other sensations.

Gaylord’s team found that three months after the therapy ended, women who’d undergone mindfulness training were faring better than the support group.

On average, their scores on a standard 500-point IBS symptom questionnaire fell by more than 100 points, with a 50-point drop considered a “clinically significant” improvement.

In contrast, women in the support group averaged a 30-point decline, according to results in the American Journal of Gastroenterology.

Chiaramonte said the trial was “tremendously well-designed,” and set up to address the common criticisms of studies of mind-body therapies. Testing mindfulness training against a support group, for example, helps control for the fact that people involved in any form of therapy may simply expect to get better — and, therefore, do.

In surveys, the researchers found that women in the support group were as likely to expect benefits as those in the mindfulness group.

“And still, the mindfulness group did better,” Chiaramonte said. “So it’s not just the contact with another human being, or not just that they expected to get better.”

It also makes sense that mindfulness training would help people with IBS, according to Chiaramonte. “Part of the problem in IBS,” she explained, “is the attention people give to the physical discomfort, and what the mind then does with that.”

With mindfulness training, the goal is to help people become aware of what they are feeling, but then “let it go” instead of ruminating, and potentially making the physical symptoms worse.

Of course, naturopathic medicine automatically takes “mindfulness” into account, so this is nothing new from my perspective. By always assessing people’s mental/emotional state, along with implementing diet and lifestyle changes, it’s not uncommon for me to see people’s IBS symptoms improve dramatically. It’s unfortunate to see so many patients who come to me after undergoing multiple symptomatic treatments (steroids, anti-spasmodics, etc.), only left to be feeling worse. 

Once again, this study demonstrates what naturopathic med
icine already practices-The impact of the mind on physical health cannot be avoided!

SOURCE: http://bit.ly/lfYimf American Journal of Gastroenterology, online June 21, 2011.

Share

IBS and Exercise

People with irritable bowel syndrome may be able to find some relief by getting regular exercise, a small clinical trial suggests.

The study, of 102 adults with the disorder, found that those who were told to get some more exercise had better odds of seeing improvements in problems like cramps, bloating, constipation and diarrhea.

After three months, 43 percent of the exercisers showed a “clinically significant” improvement in their symptoms — meaning it was making a difference in their daily lives. That compared with a quarter of the participants who maintained their normal lifestyle.

For people who are currently less-than-active, even a moderate increase in exercise may curb irritable bowel symptoms, according to senior researcher Dr. Riadh Sadik, of the University of Gothenburg in Sweden.

In an email, Sadik said the researchers had told those in the exercise group to get 20 to 60 minutes of moderate-to-vigorous exercise — like brisk walking or biking — on three to five days out of the week.

That’s a level that is generally safe and achievable, Sadik said. On top of that, the researcher added, “it will also improve your general health.”

About 15 percent of Americans have irritable bowel syndrome, or IBS, which causes bouts of abdominal cramps, bloating and diarrhea or constipation.

It is different from inflammatory bowel disease, which includes two digestive diseases — ulcerative colitis and Crohn’s disease — that are believed to involve an abnormal immune system reaction in the intestines.

The exact cause of IBS is unknown, but people with the condition often find that they have certain symptom “triggers,” such as particular foods, larger-than-normal meals or emotional stress. From a naturopathic perspective, we also look at food allergies and dysbiosis (imbalances of gut bacteria) as major underlying causes of IBS.

According to Sadik, exercise may be helpful for several reasons. Past studies have shown that it can get things moving along in the gut, relieving gas and constipation. (Vigorous exercise, however, may worsen bouts of diarrhea.)

Regular exercise may also have a positive influence on the nervous and hormonal systems that act on the digestive tract.

None of the participants in the new study, reported in the American Journal of Gastroenterology, were regularly active at the outset. The researchers randomly asked about half to begin exercising over a 12-week period, with advice from a physical therapist. The rest stuck with their normal lifestyle habits.

At the end of the study, the exercise group reported greater improvements on a standard questionnaire onIBS symptoms. They were also less likely to show worsening symptoms.

Of the exercise group, 8 percent had a clinically significant increase in IBS symptoms, versus 23 percent of the comparison group.

That, according to Sadik, suggests that for a considerable number of people remaining sedentary may only worsen IBS.

“If you have IBS, then you can increase your physical activity to improve your symptoms,” Sadik said. “If you stay inactive, you should expect more symptoms.”  

Naturopathic medicine looks at IBS as a multi-factorial condition, involving physical, mental, and emotional issues, so it makes sense that exercise would have a positive impact when it comes to treating this “condition”. If you have symptoms of IBS, but have not yet explored naturopathic treatments, it would definitely be in your best interest. 

Share
Share