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Professor Lovat
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Why I am I writing about insomnia and irritable bowel syndrome?

Insomnia is a common disorder that affects people’s quality of life and their health. Irritable bowel syndrome turns out to have many effects outside the bowel. Some people have an irritable bladder, others suffer from fibromyalgia and quite a few people also suffer from difficulties with sleeping.

In an interesting editorial in the British Medical Journal this week the whole question of managing insomnia is raised. I was fascinated by this because they point out that medicines to help people sleep have only modest effects. It turns out however that psychological treatments such as cognitive and behavioural therapy for insomnia works just as well as drugs.

Even more interestingly, the effects of CBT continue long after the intervention has stopped whereas medicines stop working as soon as you stop taking them.

In the study in the Journal of the American Medical Association they show that people who combine taking medicines and having CBT did better in the long term in terms of improving their sleeping.

Maybe it is a leap of faith but I just wonder whether a similar approach should be used in patients who come to me with irritable bowel syndrome. It is not enough just to take medicines for some of these people but alternative approaches, perhaps including CBT may well help. Indeed the evidence seems to be stacking up that this is the case.

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  1. Among functional GI experts, at least in the U.S., CBT for people with IBS is known and used and there is peer reviewed evidence that, statistically, it tends to help many more (not all, of course) people with IBS and with more lasting results than medications. This is also true of gut-directed hypnotherapy. The problem for those of us with IBS is the dearth of therapists specifically familiar withCBT as relates to IBS, even in some major metropolitan areas. Even if one or more IBS-experienced psychologists/clinical social workers may be available, the potential client/patient’s choice may be limited due to inconvenient location, scheduling, bad “fit” between individual professional and client/patient, and/or cost, which in the U.S. is often not covered by health insurance, even if an individual has insurance in general.

    I am not a medical professional, but as an advocate and educator with IBS, I have become acquainted with several of the mental health professionals in the U.S. who have become nationally and internationally well known for their expertise in this area of IBS, too many to list or link by name here. There are have been ongoing multicenter studies involving online or self-help CBT for IBS. In addition, several of these professionals maintain blogs or clinic websites and at least two have written well-regarded self-help books specifically on CBT and IBS for laypeople with IBS. One was first published in 2000, and the other in 2007. CBT is not a new concept for IBS.

    It is my hope that through continued research, awareness and advocacy, people with IBS worldwide will have broader, more accessible opportunities in our local communities to try CBT and other established and emerging IBS interventions that help us, and that medical and mental health professionals who support us will continue to work together to make that possible in the coming years. It is my intention as an advocate to continue to support their efforts.

  2. IBS can be classified as either diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), or with alternating stool pattern (IBS-A or pain-predominant). In some individuals, IBS may have an acute onset and develop after an infectious illness characterized by two or more of the following: fever, vomiting, diarrhea, or positive stool culture. This post-infective syndrome has consequently been termed “post-infectious IBS” (IBS-PI).`”-`

    Have a good day http://www.healthmedicine101.comtn

  3. Hi Admin,
    Informative blog on insomnia and like to say manage stress with regular workouts, be modest about food and drinks and avoid caffeine and nicotine specially before bedtime. Set a sleeping schedule and minimize light, noise, and extreme temperatures during sleep.

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