On this page you will learn about IBS psychology - find out why the mind is so important in your Irritable Bowel Syndrome symptoms and treatment.
There is a lot written about the so called psychology of an Irritable Bowel. It is important and there appears to be an intimate link between the two.
There's evidence that up to 50% of sufferers studied have some degree of psychiatric disorder.
This makes it a significant mental health issue and should not be neglected.
Consideration should always be given to the use of psychological therapies such as cognitive behavioural therapy, hypnosis and antidepressants.
The psychology in Irritable Bowel Syndrome does have some evidence base to it. The inference that sufferers don't have nocturnal or night time symptoms would favour this.
Also, the lack of response to medical therapies favour more than a physical link.
Antidepressants, with their ability to change the chemical messenger effects in the brain, have been used to good effect in some sufferers.
The above has brought about the theory that there is an abnormal Brain-Gut interaction.
There are a number of complex physical factors such as disordered gut motility, hypersensitivity of the gut, possibly genetic and environmental factors (diet, geography etc) which have been proposed to interact with brain perception.
IBS psychology factors are linked with both stress, anxiety and depression which are common illnesses.
Referral to a psychologist maybe helpful in some people that demonstrate these features.
NICE guidance (UK) advises the use of cognitive behavioural therapy and hypnosis in refractory symptoms.
Cognitive behavioural therapy or psychotherapy may be helpful.
This maybe one to one therapy or group therapy trying to address the thoughts, feelings, emotions and physical symptoms of the sufferer.
There have been several studies of this therapy in the psychology of Irritable Bowel Syndrome that have supported its use.
It is an ideal approach for people that would like to explore non-drug ways of dealing with their symptoms.
Hypnosis is the other option and you can read more about this on the IBS treatments page.
Medications in the form of antidepressants have been used, particularly the tricyclic Antidepressants such as Amitriptyline.
They do have side effects which can put people off taking them as well as the perceived stigma of taking such a drug.
The lowest dose is normally used and has a demonstrated benefit.
This also minimizes the common side effects such as dry mouth, blurred vision and difficulty passing urine.
Drowsiness is a welcome side effect as it helps aid sleep and the drug should always be taken at night.
They are particularly effective in patients with abdominal pain and diarrhea.
The newer antidepressants (SSRI's or Selective Serotonin Reuptake Inhibitors) have also been used in the IBS, but studies with all these drugs have been small and often use is anecdotal.
In summary, the psychology is clearly fascinating, although studies of this link have been small.
Therapy should be considered in all patients, particularly when conventional management has failed.
IBS psychology should never be neglected.