Are there alternative treatments for IBS?
There are other treatments that have been shown to be effective for IBS that are not medications. And these are typically psychological and behavioural treatments and they include Cognitive Behavioural Therapy, Interpersonal Psychotherapy, Hypnosis, and Relaxation training. They can help patients with IBS regardless of the bowel habits subtypes. There is good data to show that they are effective treatments. You would suggest Cognitive Behavioural Therapy if the patient has some mal-adaptive management skills, meaning that the way they manage or cope with their symptoms are not necessarily to their benefit. One of the types of poor scoping skills is a term known as “catastrophizing”. So for example, you have the symptoms and you are thinking, “Gee, this is terrible pain. I am never going to be able to do anything. When is this ever going to end?” That would be considered mal-adaptive or not good. And so, you train the patient to think of more positive thoughts or to focus on the present tense and not to focus on what is the end result or the subsequent factors or events that are going to occur. Interpersonal Psychotherapy would be suggested in an individual where they feel that their symptoms or their condition is impacted negatively by a stressor, whether it is a personal relationship stressor or work-related stress. Psychotherapy can often help patients with those relationships or stressors that may be negatively impacting their symptoms and then could improve their symptoms of IBS. Hypnosis is another very interesting treatment intervention. It has been studied the most in the United Kingdom by a group of investigators led by Peter Wurl. And they have done some really nice studies that have shown that hypnosis can be very beneficial in treating or relieving the symptoms of IBS but also changing the physiology of the gut making the gut less sensitive. But it is really gut-directed hypnotherapy. I think the issue is more of finding a good hypnotherapist that you get along with that would be good in treating and managing the symptoms of IBS.
