A new treatment approach helps people with IBS symptoms like stomach pain, bloating and diarrhea find relief through a combination of dietary and stress management strategies.
A new treatment approach helps people with IBS symptoms like stomach pain, bloating and diarrhea find relief through a combination of dietary and stress management strategies.
“There has been a real sea change in terms of managing patients,” says William Chey, a gastroenterologist at the University of Michigan who has documented the benefits of integrative care.
“The doctor has become an educator, somebody to help the patient to understand how he or she can help themselves.”
A miswiring of the brain-gut connection
“There’s a continuous feedback loop between the brain and the gut,” explains Suzanne Smith, a nurse practitioner at UCLA’s Integrative Digestive Health and Wellness program.
When you feel an unpleasant sensation in the body, “it’s registered as a threat, and the stress response is mounted,” she says.
“That gets that negative feedback loop going.” IBS symptoms include stomach pain, bloating and gas and sometimes urgent bowel movements or constipation. A new treatment approach helps patients learn how stress may make symptoms worse.
IBS symptoms include stomach pain, bloating and gas and sometimes urgent bowel movements or constipation. A new treatment approach helps patients learn how stress may make symptoms worse.
The brain and the gut are talking, but it’s almost as if the brain is misinterpreting the signal.
Quiet the nervous system with mindfulness and relaxation techniques
A pillar of the integrative approach and many of the apps is to help patients limit anticipatory anxiety, and halt the feedback loop that can amplify the unpleasant feelings and sensations associated with IBS symptoms.
“There was a significant improvement in quality of life and overall well-being,” Smith says. It may raise eyebrows but hypnosis is another technique shown to help quiet the nervous system. There’s no pendulum swinging in front of your face.
Gut-directed hypnotherapy combines relaxation techniques with suggestions and guided imagery to help reset communication between the gut and the brain.
“There was this sort of anxiety around the idea of leaving home, you know, the symptoms would just suddenly appear,” Mastro recalls.
“I just sort of refused to believe that, hey, this could be some form of anxiety that’s triggering,” he recalls, though he was under a lot of stress running a business.
How hypnosis can calm IBS symptoms
Hypnosis can address “the hypervigilance and hypersensitivity that happens in patients that have irritable bowel syndrome,” explains Megan Riehl, a GI clinical psychologist at the University of Michigan who has been offering patients gut-directed hypnotherapy for several years.
“Our brain and our gut are communicating all the time. And if you’re somebody that has a digestive problem, it’s like the communication is turned up way too high,” she says.
Hypnosis “helps calm that conversation down.”
“You visualize, say, your chest relaxing or your stomach relaxing, your intestines relaxing,” says Ron Berli, 75, one of Riehl’s patients who lives in Grosse Pointe Park, Michigan.
“You’re not into a deep sleep. I would call it just a deep relaxation. It’s almost like sitting in a hot tub.”
“Powerful changes are happening inside your body. Imagine the sensations of abdominal pain are becoming a thing of the past,” the soothing voice intones.
“You’re put into a very calm state,” Mastro says. And the changes or “suggestions” articulated in the 15-minute sessions start to feel real, he says.
“It’s been nothing but transformative,” Mastro says.
Zemedy from Bold Health is another CBT-based digital app that has been shown to be effective in a small trial. The benefit of the technique goes well beyond controlling symptoms of CBT.
Cognitive tools to redirect anxious thoughts
“When I started to talk about diet as an important part of treating patients with IBS at that time, people literally laughed at me,” Chey says.
Foods to avoid to manage IBS symptoms
“But now almost every gastroenterologist accepts that diet is an important part of the solution.”
“I saw the benefits almost within the first week,” says Karen Beningo of Northville, Mich., who was treated at the University of Michigan.
“The distension and the bloating went away very quick,” she says.
“It was only through calming down my system and then reintroducing [them] that I pretty much confirmed, yeah, I’ve got a problem with those things,” she explains.