Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment

Abstract

IntroductionThe study aims to investigate two kinds of treatment in patients suffering from irritable bowel syndrome (IBS) and consequently compares its efficacy on improving the symptoms and mental health of patients; one with just medical treatment and another through a combination of psychotherapy and medical treatment.Material and methodsApplying general sampling, 50 IBS patients were selected from among those who used to refer to a Gastroenterology Clinic. After physical and mental evaluations based on ROME-II scale and SCL-90-R questionnaires, the subjects were randomly superseded into: the control group with medical treatment and, the case group with a combination of medical and psychological treatments. The acquired data were then analyzed through t-test and Mann-Whitney U-test.ResultsThe findings show that the mental health of patients receiving cognitive behavioral therapy along with the medical treatment was higher than those of the control group at post-test level. It was observed that the therapy reduces the disability caused by IBS. Comparatively, while the cognitive therapy and medical treatments cured 80% of the patients, those receiving cognitive therapy alone showed an extensive reduction of symptoms.ConclusionsConsidering the role of cognitive behavioral therapy, it is therefore recommend that such patients be managed by a combined team of gastroenterologists and psychologists.

Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

“…To be as conservative and consistent in the application of our eligibility criteria as possible, trials that used quasirandomized methods of allocation (eg, assignment based on order of entry into the trial or social security number) were excluded to the extent that this could be determined. [8][9][10][11][12] Cluster randomization was considered acceptable for trials evaluating group therapies. No restrictions were placed on trial size, publication type, or follow-up interval.…”

Identifying effective techniques within psychological treatments for irritable bowel syndrome: A meta-analysis

“…A greater number of treatment sessions was associated with increased effect sizes for the physical outcomes pain [(ß = .027, k = 32, p = .02), CPSR (ß = .025, k = 34, p = .04; MahviShirazi 2012[54] excluded as outlier) and BD (ß = .033, k = 24, p = .02; Payne et al[58] excluded as outlier)]. Duration in weeks between baseline and post-treatment assessments was negatively associated with effect sizes for pain (ß = -.009), CPSR (ß = -.011), BD (ß = -.008) and HRQoL (ß = .007) (all p<0.05).…”

Comparative Efficacy of Cognitive-behavioral Therapy and Mindfulness Therapy on Reducing Symptoms and Improving Quality of life in Patients with the Irritable Bowel Syndrome

“…Based on the role of CBT and cognitivebehavioral approaches in treatment of IBS (Hunt, et al ., 2009;Lackner, 2005;Lackner, 2004;Crask, et al, 2001;Ljotsson, et al, 2010;Daryani, et al, 2010;Mahvi-Shirazi, 2012;Bunme, et al, 2004). However, all the studies namely the recent studies didn't support CBT efficacy on IBS therapy (Blanchard et al, 2007, Drossman et al, 2000, Reme et al, 2010, Ljotsson et al, 2011.…”

“…Regarding the life quality subscales, social reaction components, interpersonal relations, body image, intervention in task and avoiding eating were significant and mindfulness-based therapy method was the better. All the studies regarding the longterm effects of behavioral-cognitive therapy on reduction of the symptoms or life quality of the IBS patients showed the lack of efficacy of the therapy in long-term period (Ljotsson et al, 2010, Reme et al, 2010, Moss-Morris et al, 2010, Lackner and Gurtman, 2005, Novick et al, 2002, Camilleri et al, 2000, Mahvi-Shirazi et al, 2012, Solati Dehkordy et al, 2009, Daryani et al, 2010, Kheirabadi et al, 2009. The most important reason for these results and the lack of stability of the cognitive-behavioral therapy results is the lack of evaluation of deep cognitive factors namely the inefficient beliefs and assumptions.…”