IBS Psychological Treatment
People who are under high levels of stress or anxiety are more prone to developing IBS. These people can be thought of as having ‘IBS stress’ or ‘IBS anxiety’. Many people find that their symptoms worsen during periods of stress or anxiety. Initially your doctor may recommend you try relaxation techniques or exercising to combat stress. If however these don’t seem to be working and stress remains a key trigger of your disease, they may recommend that you undergo psychological treatment to help ease your symptoms.
Low doses of antidepressants are commonly prescribed in IBS patients, not for their effects on mental health, but because they can help to ease the pain associated with the disease by blocking the transmission of pain signals to the brain. If IBS stress and anxiety are unresponsive to traditional relaxation techniques, your doctor may wish to prescribe medication to calm you, in order to ease stress-triggered IBS symptoms, although it is likely that they will recommend therapy-based treatments before prescribing psychological medications.
Drugs that may be prescribed are one of two kinds of anti-depressants, either ‘tricyclic antidepressants’ (TCAs) such as amitryptiline, or ‘selective serotonin reuptake inhibitors’ (SSRIs) such as citalopram of fluoxetine. These drugs can be very effective in treating IBS, via both their effects on pain signals and by their relaxing effect. As they will normally only be prescribed in low doses, you should experience minimal side-effects.
Other drugs that can be used include serotonine-norepinephrine reuptake inhibitors. Although these are usually used for major depression or generalised anxiety disorder, duloxetine can be very effective in appropriately chosedn patients.
Hypnotherapy is becoming increasingly popular as a treatment option for IBS anxiety sufferers. It is thought that as there is no structural change to the bowel in IBS, the disorder may be susceptible to control through the mind.
During hypnotherapy sessions you are taught techniques for controlling and influencing your bowel function, by changing the way your brain and bowel interact. Although it is not effective in 100% of cases, many find an improvement in their symptoms following a course of hypnotherapy.
Although traditionally considered a ‘complementary’ or ‘alternative’ medicine, hypnotherapy is gaining increased support from the medical community, and you may find your doctor recommending it as a possible treatment option. In fact, there is now a considerable body of medical evidence which confirms its success.
Cognitive behavioural therapy (CBT) is a technique in which the patient and the therapist and the patient work together through a series of exercises and targets to slowly change behavioural traits that are harmful to the patient. In the case of IBS stress or IBS anxiety, it can help in you to maintain your IBS-friendly diet, encouraging positive thoughts and relaxation and help you to gain control over your symptoms, similarly to hypnotherapy. If your doctor recommends you try CBT, it’s likely that your therapist will help teach you specific strategies for relaxation, coping with symptoms, and learning to the challenges that IBS stress or IBS anxiety presents, which can have an overall positive impact on the levels of symptoms you experience.