P1110 Cognitive Behavioral Self-Help for Irritable Bowel Syndrome
Author insight from Melissa G. Hunt, PhD, University of Pennsylvania, Philadelphia, PA
What’s new here and important for clinicians?
Clinicians need to know that Cognitive-Behavioral Therapy (a specific type of talk therapy that focuses on problem solving, learning new skills and new ways to think about and manage GI symptoms) is one of the most effective treatments for Irritable Bowel Syndrome. It dramatically reduces both distress and disability and improves health related quality of life for these patients, well beyond medical management alone. Unfortunately, there just aren’t enough trained CBT therapists to go around so many patients don’t have access to that kind of treatment, and many gastroenterologists wouldn’t know where to refer their patients, even if they wanted to. This is the first study to show that a self-help book based on CBT principles and treatment strategies actually works for many patients with IBS without any additional contact with a therapist. This could dramatically improve the accessibility of effective treatment.
What do patients need to know?
Patients need to know that being referred for “psychotherapy” (even the self-help kind) does not mean that their doctor thinks their symptoms are “all in their head.” The physical symptoms of IBS are absolutely real and are both very uncomfortable and often inconvenient. But the more we learn about IBS the more we have realized that life stress and distress about symptoms can actually make symptoms worse through biological mechanisms. When IBS patients start limiting their activities (like trips and excursions, social get-togethers or any event involving food for fear of having a flare up) life starts to get pretty depressing and anxiety provoking. This is a big part of what causes the distress and disability associated with IBS, and it actually makes symptoms worse and reduces quality of life. CBT gives patients specific tools and skills to learn to manage stress and reduce the impact IBS symptoms have on living life.
Melissa G. Hunt, PhD, University of Pennsylvania, Philadelphia, PA
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P1719 Regional Variation of Care for Irritable Bowel Syndrome in the United States
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