Efficacy of training in stress and contingency management in cases of irritable bowel syndrome

Abstract

Forty patients with irritable bowel syndrome were assigned at random to four treatment conditions (two experimental groups: training in stress management and training in contingency management; and two control groups: medical treatment and placebo). In each of the groups (N = 10), care was taken to ensure that half the cases were suitable for training in stress management due to the respondent nature of the illness in these cases and the other half suitable for training in contingency management due to the operant nature of their problem. The patients underwent six individual sessions of specific treatment according to the condition. All of the subjects completed symptom‐monitoring diaries. In the post‐treatment, a MANOVA of mixed factorial design was carried out to analyse the interaction between the suitability of the patient and the type of treatment for the global value of the symptomatology and for each symptom. The results showed that statistically significant changes occurred depending on the interaction between suitability‐treatment p < 0.1) and on the type of treatment (p < 0.05). The clinical changes recorded by the gastroenterologist were maintained after a year. An analysis is made of the behavioural predictors of the resolution of the patients according to suitability and the type of treatment. Copyright © 2006 John Wiley & Sons, Ltd.

Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

“…Of the 220 articles reviewed in detail, 66 articles comprising 6764 total participants were included ( Figure 1) in the final analysis . Three studies 31,37,38 examined more than one intervention compared to separate control arms and were included separately. Study characteristics are shown in Table 1.…”

“…Egger's test showed asymmetry of the funnel plot (p=0.07) due to two studies. 37,43 Data on efficacy of mind-body based therapy for overall response in IBS were available in 12 papers containing 12 RCTs evaluating 1539 patients. Mind-body based therapy was associated with benefit over placebo (RR=1.67, 95% CI: 1.13 to 2.49, I 2 =63%, [ Supplementary Figure 9]),, corresponding to an NNT of 5 (95% CI: 3 to 25) with moderate heterogeneity and low confidence in estimates.…”

Complementary and Alternative Medicine and Mind–Body Therapies for Treatment of Irritable Bowel Syndrome in Women

“…While these studies suggested immediate relief of symptoms by IPP, it is unclear how long the treatment effect lasts. The studies of relaxation and stress relief reported symptom improvement, including abdominal pain, but may depend on the suitability of the patient to the therapy [70]. Boyce et al showed symptom improvement over time, but there was no difference in the type of therapy in patients (80% women) treated with ‘usual therapy’, CBT or relaxation techniques [71].…”