Helping the brain heal the intestines

Summary: Researchers say that using psychological interventions, such as CBT, can help reduce anxiety and other symptoms associated with IBS.

A source: University of Pennsylvania

On its surface, subreddit for irritable bowel syndrome (IBS) is a tongue-in-cheek humor nest; Its logo depicts the classic Reddit alien holding his gut in awkwardness, with many of the stratified memes and the most active members sitting on a “porcelain throne”.

However, in the online community, members of this disorder share stories that cover almost every aspect of their lives with shame and embarrassment. In some cases, the resulting anxiety, depression, and avoidance can be debilitating, disabling, and even life-threatening.

“Take 10 minutes for an IBS subredit, and at least one person who commits suicide will write on that list, ‘I can’t take it anymore. It’s ruined my life,'” said Melissa Hunt, a clinical psychologist at Penn’s Department of Psychology.

This is part of Hunt’s nearly two decades of research and treatment of IBS, and why he has just published the second edition of his book, Recover Your Life from IBS, which offers a proven treatment plan for those suffering from the disease.

A year after the first edition was published, Hunt found copies on eBay that sold for hundreds of dollars. In response to a request, he wanted an update that included more tools to help with treatment, as well as a review of the latest advances in the field.

Intestinal-brain connection

One of the most important achievements is a deeper understanding of the mechanism of IBS, which is now characterized as a disorder of intestinal-brain interaction, says Hunt. In people without IBS, signals from the gut, which may go unnoticed, pass into the gut and are interpreted by the brain as pain or an urgent need for movement. While this can lead to anxiety, the gut is lined with stress hormone receptors and responds with contractions and spasms.

“Then you race with a positive mindset to increase the brain’s vigilance, and then the hypersensitivity in the gut,” Hunt says.

Symptomatically, IBD appears to be abdominal pain and constipation, diarrhea, or a combination of both, and according to some estimates, about 15% of the population struggles with some form of the disease.

For people who are more prone to diarrhea, frequent visits to the toilet or being too far from a comfortable toilet can lead them to avoid social situations and may ultimately be seen as agoraphobia.

“People become incredibly paranoid,‘ I have an attack because I can’t go to a restaurant. I don’t want to be away from the table and be away from everyone, but what if the toilet is occupied? It would be an accident, so I have to stay home, “Hunt said.” Your life will get really small really fast. “

The shrinking nature of the situation, often combined with physical discomfort, can lead to helplessness. Many take extreme measures in the form of dietary restrictions or multiple medications, usually in an attempt to reduce symptoms.

However, the effectiveness and side effects of many clinical interventions, such as treatment with laxatives or antibiotics, can vary. For example, a diet that works well to treat IBS symptoms, known as “low FODMAP,” is so limited that it is almost impossible to adhere to unless patients are able to prepare each meal on their own, Hunt says. On the contrary, this diet can damage the health of the gut by starving the important bacteria in the gut, he says.

All of these treatments focus on the “gut” side of the gut-brain interaction. Instead, Hunt focuses on the brain. She uses cognitive behavioral therapy to help patients reduce anxiety and hypersensitivity around their gut feelings, and encourages them to gradually adjust to diet and situations associated with individual IBS symptoms.

It also teaches them to stop the catastrophe and to fall into a mental trap where the worst is inevitable. This method actually leads to a decrease in visceral sensitivity, which allows people to relieve symptoms while eating what they want.

“If half of what happens in IBS is that the brain is interpreting these signals, then therapy that helps interpret those signals in a different way will help,” says Hunt.

“So talking about it changes their urgency diarrhea, it’s hard to believe for some patients at first.”

make treatment available

When Hunt initially tested and published a study of low-intensity CBT treatment involving a limited but active therapist, he was amazed at its effectiveness in reducing symptoms and improving quality of life, he said. Several of his peers encouraged him to do more research and to publish more on the subject.

See also

While more research seems prestigious, Hunt said he can reach more patients and treatment providers with a self-help book. Thus, he wrote the first edition, which was tested in a randomized controlled trial, the gold standard for studying the effectiveness of treatment.

This indicates that the person is holding his stomach
One of the most important achievements is a deeper understanding of the mechanism of IBS, which is now characterized as a disorder of intestinal-brain interaction, says Hunt. Image in public domain

As in the first study, the participating patients had a consistent improvement in their quality of life and IBS symptoms.

In its second edition, it examines medical advances over the past decade. He added a section on diet, where recent research on restrictive diets and healthy eating habits can help alleviate symptoms.

She also explores the benefits of exercise and ways to help people motivate themselves in that arena without any criticism.

Hunt said he hopes the new publication will be useful for patients and clinics, including gastroenterologists and therapists.

Throughout the book, it offers more clinical anecdotes to help readers find a resonant story, and it ends with the story of two fake patients to show how someone can work with a therapist and without a therapist.

Finally, Hunt said, the book provides accessible, scientifically proven help to people with IBS subdredits.

“The real goal of treating IBS is to restore people’s lives without causing them to go away,” Hunt said.

“You may have GI discomfort from time to time – everyone can – but you can still live a very rich, meaningful life.”

It’s about gut health and psychology research news

Author: Luis Melesio-Zambrano
A source: University of Pennsylvania
The connection: Luis Melesio-Zambrano – University of Pennsylvania
Photo: Image in public domain

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