Cognitive Behavioral Therapy for Irritable Bowel Syndrome

If you have Irritable Bowel Syndrome (IBS) you may be struggling with gastrointestinal (GI) pain and discomfort that sometimes interrupts your daily life. You likely use medical and dietary interventions to manage and control your symptoms. Unfortunately, research shows these interventions do not always offer consistent results and many people with IBS continue to experience challenging symptoms.

What you may not have heard about is that research shows that psychological techniques are also helpful for managing IBS. Since our biology, behaviors, thoughts, and emotions all influence our health, psychotherapy approaches such as Cognitive Behavioral Therapy (CBT) can have a significant impact on the symptoms of IBS and quality of life. Research confirms that by addressing thinking and behavior with CBT, we can also improve GI functioning and symptoms of IBS.

A Brief Review of CBT:

CBT is a structured therapy approach with a focus on setting goals and finding solutions to present day concerns. CBT helps to change harmful thought patterns and behaviors, replacing them with more helpful and adaptive thoughts and behaviors. CBT works for IBS through a variety of mechanisms, for example CBT can improve physical symptoms through reducing stress, lowering inflammation, and learning new coping mechanisms.

How Exactly Does CBT help IBS?

Research and experience show that the symptoms of Irritable Bowel Syndrome tend to worsen or “flare up” during times of stress. This is due to strong links between our gastrointestinal system and our brain. By learning how to manage stress we can help to lower the symptoms of IBS.

Let’s consider the role of the autonomic nervous system in IBS. During stress, the sympathetic system gets activated in the body and can stay in overdrive for a long time in a “fight or flight” pattern of nervous system activation that negatively affects the GI system. CBT works in part through increasing parasympathetic activity and rebalancing the nervous system activation. Parasympathetic nervous system activation, the “rest and digest” response, calms the body and gastrointestinal activity.

Research also shows that people with IBS are often hypervigilant to the activities of their gastrointestinal system and the body in general. By helping individuals learn how to redirect their thinking, CBT helps in becoming less vigilant of the activities of the gastrointestinal tract. Cognitive restructuring and shifts in focus of attention can reduce symptoms and improve quality of life.

In addition to teaching ways to reduce stress, CBT can also help people learn techniques and strategies for managing their IBS symptoms, so they can lead fuller lives. For example, CBT therapists can help clients identify trigger foods to be avoided. CBT therapists can also help clients establish new eating, sleeping, and daily schedules that might better match their particular bodies needs.

Further, people with IBS often first learn to deal with their symptoms by engaging in avoidance, until a diagnosis is made and initial symptoms are treated. Individuals with IBS may then struggle to get back to their daily lives even with medical, dietary, and CBT interventions, due to fears and continued use of avoidance. CBT can use exposure techniques to help individuals regain comfort in going about daily activities.

How effective is CBT for IBS?

CBT is one psychological approach found to be helpful in treating IBS.  Research findings suggest that CBT may be especially helpful for favorable long-term outcomes. Researchers found that brief interventions and “check-ins” are helpful for patients to achieve long-term benefits. These “check-in” or follow up sessions help patients to consult about how they are using CBT skills, to continue refining the CBT skills they have learned, and to identify any new skills they may need.

Summary and Conclusions

If you have Irritable Bowel Syndrome and are seeking additional ways to reduce and manage your symptoms, then you may want to consider integrating Cognitive Behavioral Therapy into your treatment. We are a group practice focusing on integrative treatment of mind body conditions and our group of Brooklyn psychotherapists and psychiatrists work with many individuals with IBS.