{"id":121517,"date":"2019-01-08T06:30:22","date_gmt":"2019-01-08T12:30:22","guid":{"rendered":"http:\/\/www.granitepeaksgi.com\/?p=121517"},"modified":"2019-08-13T13:09:02","modified_gmt":"2019-08-13T19:09:02","slug":"treating-ibs-with-cognitive-behavioral-therapy","status":"publish","type":"post","link":"https:\/\/www.granitepeaksgi.com\/treating-ibs-with-cognitive-behavioral-therapy\/","title":{"rendered":"Treating IBS with Cognitive Behavioral Therapy"},"content":{"rendered":"<p>By <a href=\"http:\/\/www.granitepeaksgi.com\/physician\/christopher-s-cutler-md-2\/\">Christopher Cutler, M.D.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/a><\/p>\n<style>.embed-container { position: relative; padding-bottom: 56.25%; height: 0; overflow: hidden; max-width: 100%; } .embed-container iframe, .embed-container object, .embed-container embed { position: absolute; top: 0; left: 0; width: 100%; height: 100%; }<\/style>\n<div class=\"embed-container\"><iframe src=\"https:\/\/www.youtube.com\/embed\/u_Db7T-etCc\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<p>&nbsp;<\/p>\n<p><b>Irritable bowel syndrome (IBS)<\/b>\u00a0affects 10-15% of adults in the United States.\u00a0 It is a functional disorder of the gastrointestinal tract characterized by abdominal pain and altered bowel habits.\u00a0 <a href=\"http:\/\/www.granitepeaksgi.com\/condition\/irritable-bowel-syndrome-ibs\/\">IBS<\/a> is usually treated with dietary modifications and medications directed at underlying symptoms (diarrhea, constipation, abdominal pain, bloating).\u00a0 Patients may also receive benefit from antidepressants, probiotics, and antibiotics.\u00a0 But what about patients with refractory symptoms that do not respond to traditional therapies?\u00a0 What are their options?\u00a0 One promising alternative to consider is\u00a0<b>cognitive behavioral therapy (CBT)<\/b>.\u00a0 CBT is a short-term therapy (4-10 one hour sessions with a therapist) that focuses on modifying behaviors and altering dysfunctional thinking in hopes of improving mood and GI symptoms.\u00a0<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b>The Brain-Gut Connection<\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p>In patients with IBS, there is dysregulation of the gut brain axis, a complex neurologic communication between the brain and GI tract.\u00a0 Stress and psychological factors can directly influence gut function via this pathway, contributing to IBS symptoms.\u00a0 Patients with IBS have an increased tendency to experience pain in response to normal bowel function.\u00a0 This may be attributed in part to abnormal pain processing in the brain.\u00a0 People affected by IBS also have a fear of bowel symptoms and associated avoidance of situations where symptoms may occur.\u00a0 It is a vicious cycle since symptoms themselves become a stressor, and this anxiety contributes to increased gut pain sensitivity and altered motility causing worse GI symptoms and worse anxiety.\u00a0\u00a0<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p>Given the importance of brain-gut interactions in IBS, psychological interventions are an effective option for this condition.\u00a0 These modalities may include cognitive behavioral therapy, hypnotherapy, and mindfulness.\u00a0 CBT has been the most extensively studied with more than 20 published randomized clinical trials showing relief of IBS symptoms in 50-70% of patients.\u00a0 These benefits are frequently maintained for up to one year after therapy.\u00a0<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b>Treating IBS with CBT<\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p>CBT involves relaxation strategies such as specialized deep breathing.\u00a0 This increases the patient\u2019s awareness of the connection between distorted thinking patterns, stress, and digestive symptoms.\u00a0 CBT also helps patients develop coping strategies by encouraging them to shift from a solution-focused approach to a self-management approach to deal with this chronic condition.\u00a0 CBT also uses exposure techniques which involve facing situations the patient avoids because of fear of symptoms.\u00a0 With time, avoidance behaviors decrease and the thought of symptoms being harmful is reduced.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p>The American Gastroenterology Association recommends psychological interventions for patients with moderate-to-severe IBS who do not respond to standard medical therapies, and for patients for whom psychological factors exacerbate their symptoms.\u00a0 CBT is an effective treatment option for patient with IBS, and its use to treat this disorder is becoming more widely accepted.\u00a0 The physicians at Granite Peaks are experts in the diagnosis and therapy of IBS and are eager to help you.\u00a0 Please call us to discuss traditional and alternative strategies to help you manage your IBS symptoms.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Christopher Cutler, M.D.\u00a0 &nbsp; Irritable bowel syndrome (IBS)\u00a0affects 10-15% of adults in the United States.\u00a0 It is a functional disorder of the gastrointestinal tract characterized by abdominal pain and altered bowel habits.\u00a0 IBS is usually treated with dietary modifications and medications directed at underlying symptoms (diarrhea, constipation, abdominal pain, bloating).\u00a0 Patients may also receive 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