Irritable Bowel Syndrome Relief: Home-Based Treatment Can Ease Symptoms

Can you use your mind to treat your gut? And can it be as beneficial as visiting a doctor and seeking medical treatment? You may be convinced by the findings of the largest federally funded non-drug clinical trial for irritable bowel syndrome (IBS).

In the new study, patients who suffered from IBS were able to use psychotherapy to control severe and persistent symptoms. Based on responses from both physicians and patients, the home-based treatment provided similar relief to those who were treated with multiple clinic visits.

Published in Gastroenterology on April 23, the landmark study was a result of 20 years of funding from the National Institute of Diabetes, Digestive, and Kidney Diseases. It was led by researchers from the University at Buffalo (UB) in collaboration with colleagues at New York University and Northwestern University.

IBS is a common disorder affecting the large intestine, characterized by abdominal pain, diarrhea, and constipation. In the United States, 10 to 15% of the population suffer from symptoms but only 5 to 7% get diagnosed with the disease. Many patients report a reduced quality of life due to complications in their mood, diet, and social interactions. While exact figures vary, IBS has been estimated to cost the U.S. almost $28 billion annually.

436 patients of IBS were recruited at UB and Northwestern for the trial. Two weeks after home-based behavioral treatment ended, 61% reported symptom improvement compared to 55% in clinic-based treatment. The benefits endured for as long as six months after treatment ended. 

As a part of the "novel, game-changing treatment approach," cognitive behavioral therapy (CBT) was used to teach patients practical skills. This included information on brain-gut interactions, self-monitoring of symptoms, triggers, consequences, muscle relaxation, stress control and problem-solving. 

In addition to 4 or 10 clinic sessions, patients were also provided with self-study materials developed by lead author Dr. Jeffrey Lackner, a professor in the Department of Medicine in the Jacobs School of Medicine and Biomedical Sciences at UB. "The treatment is based on cutting-edge research that shows that brain-gut connection is a two-way street," he explained.

"Our research shows that patients can learn ways to recalibrate these brain-gut interactions in a way that brings them significant symptom improvement that has eluded them through medical treatments."

Given that IBS is predominantly diagnosed in women, Dr. Lackner stated the study was noteworthy because 20% of the patients were male, a group that is generally reluctant to seek treatment. He explained that they would be "more likely to reach out for help" if provided a home-based treatment option. Since clinician contact was minimal through the trial, it also meant that high-quality treatment, previously limited to metropolitan areas, could be made accessible to patients in rural areas.

"These findings will be welcomed by many women and men, who have unfortunately been stigmatized, marginalized and too often treated as ‘head cases’ merely because no definitive cause for their symptoms is identified through routine medical testing," said Dr. Lackner.