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Irritable Bowel Syndrome Isn't All in Your Head, But Docs Say Therapy Can Help

Doctors and scientists are further exploring the connection between gut bacteria and mental health.
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ByLIZ NEPORENT
April 28, 2015, 9:37 AM

— -- There is a very real link between psychological stress and irritable bowel syndrome, doctors acknowledge. That’s why people who suffer from the pain, diarrhea and constipation associated with the syndrome often get a referral to a psychologist.

“Anxiety and other thoughts can trigger symptoms of IBS,” noted Jeffrey Brown, a cognitive-behavioral psychologist with the department of psychiatry at Harvard Medical School. “It’s truly a representation of the mind-body connection.”

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While the specific cause of IBS is unknown, it seems the nerves and muscles that control the bowel are to blame, according to the International Foundation for Functional Gastrointestinal Disorders. Symptoms may result from a disturbance in the way the gut, brain and nervous system interact. Stress does not cause the condition but it can make it worse, the foundation's website said.

Approximately 15 percent of the population in the U.S. suffers from IBS, the foundation estimates. Women are 1.5 times more likely than men to be diagnosed with the condition. It accounts for between 20 percent and 40 percent of all visits to the gastroenterologist, the type of specialty doctor that diagnoses and treats the syndrome with medications.

Brown said IBS is often a diagnosis of last resort after everything from cancer to intestinal blockage has been ruled out. And psychological treatment of any kind is often the last stop after years of suffering for many people, he said.

There is no cure for IBS and, while there are few studies comparing cognitive behavioral therapy, or CBT, to other forms of treatment, including antidepressants, which doctors sometimes prescribe to their IBS patients, Brown said it works by challenging the negative thought patterns to alter unwanted behavior and emotional patterns often associated with IBS.

“You might start by staying out a little longer to test your belief that you can’t leave home without getting into trouble,” Brown said. “Gradually you extend those periods of time out until you start to realize you can do it.”

Altering thought patterns can help someone accept they have a problem, said Brown, who has counseled many IBS patients in his practice. If someone has a sudden attack of diarrhea while out shopping, therapy can give them the psychological tools they need to keep calm and manage their reaction, he added.

“IBS can be unpredictable and you can’t always change it but you can change how you approach it psychologically," Brown said. "It isn’t pleasant but it doesn’t have to be the end of the world either."

IBS Tweet Chat Today at 1 p.m. ET

IBS has been called the number one health problem no one wants to talk about. Well, today the ABC News health team, along with experts, advocates and patients from all over the country, are starting a conversation about this condition in the form of a tweet chat.

Please join us today for this chat to learn everything you need to know about IBS, including symptoms, diagnosis and treatment. Finding and joining the chat on Twitter is easy. Here’s how.

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